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NPI Code Detail

MEDICARE: LISA ALLOMONG I PCC-S

MEDICARE: LISA ALLOMONG I PCC-S
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
1101YP2500XProfessional CounselorE-0002111OH

General Provider Information

NPI Number : 1194278283
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA ALLOMONG I PCC-S
Provider Business Mailing Address
First Line : 23701 MILES RD
Second Line :
City : CLEVELAND
State : OH
Zip : 44128-5473
Country : US
Telephone Number : 216-763-0800
Fax Number :
Provider Business Practice Location Address
First Line : 23701 MILES RD
Second Line :
City : CLEVELAND
State : OH
Zip : 44128-5473
Country : US
Telephone Number : 216-763-0800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2016
Last Update Date : 07/26/2016

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Directions to “ LISA ALLOMONG I PCC-S” Practice Location

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