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NPI Code Detail

MEDICARE: MS. JOLANDA MARIE PEEPLES CDCA

MEDICARE: MS. JOLANDA MARIE PEEPLES CDCA
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
1101YA0400XAddiction (Substance Use Disorder) CounselorOH

General Provider Information

NPI Number : 1942787940
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JOLANDA MARIE PEEPLES CDCA
Provider Business Mailing Address
First Line : 3135 LORAIN AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44113-3407
Country : US
Telephone Number : 216-212-4455
Fax Number :
Provider Business Practice Location Address
First Line : 3135 LORAIN AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44113-3407
Country : US
Telephone Number : 216-212-4455
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2018
Last Update Date : 07/23/2018

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