Healthcare Provider Details

I. General information

NPI: 1922769074
Provider Name (Legal Business Name): CHIARA MCGOWAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2021
Last Update Date: 12/30/2021
Certification Date: 12/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12417 DARLINGTON AVE
GARFIELD HEIGHTS OH
44125-3750
US

IV. Provider business mailing address

12417 DARLINGTON AVE
GARFIELD HEIGHTS OH
44125-3750
US

V. Phone/Fax

Practice location:
  • Phone: 216-336-5262
  • Fax:
Mailing address:
  • Phone: 216-336-5262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: