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General NPI Number Information
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NPI Number | 1376053496
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Entity Type | Individual
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Provider Name | KEZIA DENEE' HALL LISW-S
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Gender | Female
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Dates
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Enumeration Date | 10/03/2017
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 5198 RICHMOND RD
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City | BEDFORD HEIGHTS
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State | OH
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Zip | 44146-1331
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Country | US
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Telephone | 216-235-2410
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Fax |
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Provider Business Mailing Address
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Address Line | 618 GLOUCESTER DR
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City | HIGHLAND HEIGHTS
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State | OH
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Zip | 44143-2031
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Country | US
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Telephone | 216-235-2410
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | I.2203736
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License Number State | OH
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