Provider Demographics
NPI:1851772412
Name:WOODS, SHATOYA
Entity Type:Individual
Prefix:
First Name:SHATOYA
Middle Name:
Last Name:WOODS
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 1:16024 LAKE SHORE BLVD APT 317
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44110-4001
Mailing Address - Country:US
Mailing Address - Phone:216-609-8054
Mailing Address - Fax:
Practice Address - Street 1:16024 LAKE SHORE BLVD APT 317
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44110-4001
Practice Address - Country:US
Practice Address - Phone:216-609-8054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-09
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide