Provider Demographics
NPI:1558965061
Name:MOYE, SONNYTTA JARVA
Entity Type:Individual
Prefix:
First Name:SONNYTTA
Middle Name:JARVA
Last Name:MOYE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SONNYTTA
Other - Middle Name:JARVA
Other - Last Name:MOYE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:STNA
Mailing Address - Street 1:3460 W 49TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44102-6042
Mailing Address - Country:US
Mailing Address - Phone:216-355-7079
Mailing Address - Fax:
Practice Address - Street 1:3460 W 49TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44102-6042
Practice Address - Country:US
Practice Address - Phone:216-355-7079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH371865550197251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care