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General NPI Number Information
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NPI Number | 1538925417
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Entity Type | Individual
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Provider Name | DOMONIQUE RENEE' HILL
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Gender | Female
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Dates
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Enumeration Date | 02/27/2024
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Last Update Date | 02/27/2024
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Provider Practice Location Address
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Address Line | 2728 EUCLID AVE
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City | CLEVELAND
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State | OH
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Zip | 44115-2429
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Country | US
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Telephone | 216-243-6260
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Fax |
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Provider Business Mailing Address
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Address Line | 3777 E ANTISDALE RD
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City | CLEVELAND
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State | OH
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Zip | 44118-2327
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Country | US
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Telephone | 216-744-3948
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | OH
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