Healthcare Provider Details

I. General information

NPI: 1932091907
Provider Name (Legal Business Name): MARIETTA KAYE MACK-HOOD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2025
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17325 EUCLID AVE STE 3144
CLEVELAND OH
44112-1256
US

IV. Provider business mailing address

849 HUNTER RIDGE DR
STREETSBORO OH
44241-4332
US

V. Phone/Fax

Practice location:
  • Phone: 216-534-9488
  • Fax:
Mailing address:
  • Phone: 216-534-9488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: