Healthcare Provider Details

I. General information

NPI: 1649089004
Provider Name (Legal Business Name): MONIQUE MCGLOTHIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/31/2024
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7651 GARDEN VALLEY AVE APT 1
CLEVELAND OH
44104-4227
US

IV. Provider business mailing address

7651 GARDEN VALLEY AVE APT 1
CLEVELAND OH
44104-4227
US

V. Phone/Fax

Practice location:
  • Phone: 216-203-1868
  • Fax:
Mailing address:
  • Phone: 216-203-1868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: