Healthcare Provider Details

I. General information

NPI: 1497509145
Provider Name (Legal Business Name): MICHELLE L WESTOVER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2024
Last Update Date: 04/17/2024
Certification Date: 04/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 E 200TH ST STE 200
EUCLID OH
44119-1562
US

IV. Provider business mailing address

503 E 200TH ST STE 200
EUCLID OH
44119-1562
US

V. Phone/Fax

Practice location:
  • Phone: 440-553-0165
  • Fax:
Mailing address:
  • Phone: 440-553-0165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: