Healthcare Provider Details

I. General information

NPI: 1083545321
Provider Name (Legal Business Name): DA'MIA PENDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17710 S MILES RD
CLEVELAND OH
44128-3916
US

IV. Provider business mailing address

17710 S MILES RD
CLEVELAND OH
44128-3916
US

V. Phone/Fax

Practice location:
  • Phone: 216-339-5732
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number33027737
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: