Healthcare Provider Details

I. General information

NPI: 1780594069
Provider Name (Legal Business Name): MELISSA CUMMINGS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13302 THORNHURST AVE
GARFIELD HEIGHTS OH
44105-6847
US

IV. Provider business mailing address

13302 THORNHURST AVE
GARFIELD HEIGHTS OH
44105-6847
US

V. Phone/Fax

Practice location:
  • Phone: 440-533-8540
  • Fax:
Mailing address:
  • Phone: 440-533-8540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372500000X
TaxonomyChore Provider
License Number201802604108
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: