Healthcare Provider Details

I. General information

NPI: 1346039641
Provider Name (Legal Business Name): WHITNEY CHEVELLE AULT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2025
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4707 CLIFTON AVE
LORAIN OH
44055-3069
US

IV. Provider business mailing address

4707 CLIFTON AVE
LORAIN OH
44055-3069
US

V. Phone/Fax

Practice location:
  • Phone: 440-850-4838
  • Fax:
Mailing address:
  • Phone: 440-850-4838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: