Healthcare Provider Details

I. General information

NPI: 1447939657
Provider Name (Legal Business Name): LESA RENEE MORRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2023
Last Update Date: 02/29/2024
Certification Date: 02/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

358 RICHMOND RD
RICHMOND HTS OH
44143-1401
US

IV. Provider business mailing address

358 RICHMOND RD
RICHMOND HTS OH
44143-1401
US

V. Phone/Fax

Practice location:
  • Phone: 216-925-6558
  • Fax:
Mailing address:
  • Phone: 216-925-6558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License NumberRS000541
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: