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NPI Code Detail

MEDICARE: HALEIGH GAINES

MEDICARE:   HALEIGH  GAINES
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
1133V00000XRegistered DietitianLD.8152OH

General Provider Information

NPI Number : 1962115998
Entity Type Code : Individual
Provider Name (Legal Business Name) : HALEIGH GAINES
Provider Business Mailing Address
First Line : 3623 ANTISDALE AVE
Second Line :
City : CLEVELAND HEIGHTS
State : OH
Zip : 44118-2205
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3623 ANTISDALE AVE
Second Line :
City : CLEVELAND HEIGHTS
State : OH
Zip : 44118-2205
Country : US
Telephone Number : 216-870-1963
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2023
Last Update Date : 01/04/2023

Similar Medicare Providers

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Directions to “ HALEIGH GAINES ” Practice Location

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