Healthcare Provider Details

I. General information

NPI: 1649964198
Provider Name (Legal Business Name): ASONDRA STARN'AIR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2023
Last Update Date: 06/07/2023
Certification Date: 06/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20190 FULLER AVE
EUCLID OH
44123-2635
US

IV. Provider business mailing address

20190 FULLER AVE
EUCLID OH
44123-2635
US

V. Phone/Fax

Practice location:
  • Phone: 216-650-7464
  • Fax:
Mailing address:
  • Phone: 216-650-7464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: