Provider Demographics
NPI:1376314658
Name:GREATHOUSE, STANYA M (MA, M ED)
Entity Type:Individual
Prefix:MS
First Name:STANYA
Middle Name:M
Last Name:GREATHOUSE
Suffix:
Gender:F
Credentials:MA, M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10907 HULDA AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44104-3550
Mailing Address - Country:US
Mailing Address - Phone:614-902-5895
Mailing Address - Fax:
Practice Address - Street 1:27801 EUCLID AVE STE 600
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44132-3548
Practice Address - Country:US
Practice Address - Phone:216-562-9960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No374K00000XNursing Service Related ProvidersReligious Nonmedical Practitioner