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General NPI Number Information
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NPI Number | 1891514048
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Entity Type | Individual
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Provider Name | DANA MELINE DRAVENSTOTT LISW-S
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Gender | Female
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Dates
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Enumeration Date | 10/05/2024
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Last Update Date | 10/05/2024
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Provider Practice Location Address
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Address Line | 2500 METROHEALTH DR
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City | CLEVELAND
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State | OH
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Zip | 44109-1900
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Country | US
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Telephone | 216-778-7682
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Fax |
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Provider Business Mailing Address
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Address Line | 5848 TRYSTIN TREE DR
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City | MEDINA
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State | OH
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Zip | 44256-6436
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Country | US
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Telephone | 440-915-6171
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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 | 1.0009748
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License Number State | OH
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