MEDICARE: NADINE DUGGER MSSA,LSW

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	1041C0700X	Clinical Social Worker	S22991	OH

General Provider Information

NPI Number	:	1164959896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NADINE DUGGER MSSA,LSW

Provider Business Mailing Address
First Line	:	1276 W 3RD ST STE 210
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44113-1512
Country	:	US
Telephone Number	:	216-443-5633
Fax Number	:

Provider Business Practice Location Address
First Line	:	1276 W 3RD ST STE 210
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44113-1512
Country	:	US
Telephone Number	:	216-443-5633
Fax Number	:

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

Provider Enumeration Date	:	05/12/2017
Last Update Date	:	05/12/2017

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