MEDICARE: REGINA CLEARY

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	3747P1801X	Personal Care Attendant
2	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1437525250
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REGINA CLEARY

Provider Business Mailing Address
First Line	:	35 N VALLEY ST
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44303-2013
Country	:	US
Telephone Number	:	330-945-0642
Fax Number	:

Provider Business Practice Location Address
First Line	:	35 N VALLEY ST
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44303-2013
Country	:	US
Telephone Number	:	330-945-0642
Fax Number	:

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

Provider Enumeration Date	:	08/16/2015
Last Update Date	:	08/16/2015

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Directions to “ REGINA CLEARY ” Practice Location

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