MEDICARE: MS. RHONDA L DAVIS-LOVEJOY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	S4169	OH

General Provider Information

NPI Number	:	1063704872
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RHONDA L DAVIS-LOVEJOY

Provider Business Mailing Address
First Line	:	3607 BLANCHE AVE
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-2211
Country	:	US
Telephone Number	:	216-233-7178
Fax Number	:	216-451-1765

Provider Business Practice Location Address
First Line	:	3607 BLANCHE AVE
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-2211
Country	:	US
Telephone Number	:	216-233-7178
Fax Number	:	216-451-1765

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2011
Last Update Date	:	05/11/2011

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