Provider Demographics
NPI:1245988369
Name:BELCHER, DOMINEK SENISE
Entity type:Individual
Prefix:MS
First Name:DOMINEK
Middle Name:SENISE
Last Name:BELCHER
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 1:5650 S PROSPECT ST APT 110
Mailing Address - Street 2:
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-3659
Mailing Address - Country:US
Mailing Address - Phone:440-214-2762
Mailing Address - Fax:
Practice Address - Street 1:5650 S PROSPECT ST APT 110
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-3659
Practice Address - Country:US
Practice Address - Phone:440-214-2762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-17
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty