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General NPI Number Information
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NPI Number | 1083419824
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Entity Type | Individual
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Provider Name | RUBY DEBINESE WATSON
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Gender | Female
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Dates
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Enumeration Date | 02/17/2025
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Last Update Date | 02/17/2025
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Provider Practice Location Address
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Address Line | 16000 TERRACE RD APT 612
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City | EAST CLEVELAND
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State | OH
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Zip | 44112-2069
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Country | US
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Telephone | 216-268-9855
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Fax |
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Provider Business Mailing Address
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Address Line | 725 E 159TH ST
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City | CLEVELAND
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State | OH
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Zip | 44110-2415
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Country | US
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Telephone | 216-235-7268
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State | OH
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