Healthcare Provider Details

I. General information

NPI: 1104557313
Provider Name (Legal Business Name): CHRISTINA THOMPSON-MEANS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2022
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5908 BONNA AVE
CLEVELAND OH
44103-1695
US

IV. Provider business mailing address

5908 BONNA AVE
CLEVELAND OH
44103-1695
US

V. Phone/Fax

Practice location:
  • Phone: 216-681-3657
  • Fax:
Mailing address:
  • Phone: 216-681-3657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number1042229
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: