Healthcare Provider Details

I. General information

NPI: 1053710632
Provider Name (Legal Business Name): MONICA KLEEBERGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2014
Last Update Date: 06/06/2025
Certification Date: 05/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4833 DARROW RD STE 101
STOW OH
44224-1411
US

IV. Provider business mailing address

4833 DARROW RD STE 10
STOW OH
44224-1411
US

V. Phone/Fax

Practice location:
  • Phone: 330-650-5338
  • Fax: 330-342-3837
Mailing address:
  • Phone: 330-650-5338
  • Fax: 330-342-3837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: