Provider Demographics
NPI:1437766243
Name:CLAY, MARIE L
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:L
Last Name:CLAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8200 ROSEWOOD AVE # UP
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44105-6683
Mailing Address - Country:US
Mailing Address - Phone:121-650-2133
Mailing Address - Fax:
Practice Address - Street 1:8200 ROSEWOOD AVE # UP
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44105-6683
Practice Address - Country:US
Practice Address - Phone:121-650-2133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-25
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator