Provider Demographics
NPI:1811739154
Name:CONWAY, RICHONNA D
Entity type:Individual
Prefix:
First Name:RICHONNA
Middle Name:D
Last Name:CONWAY
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 1:600 TURNEY RD APT 216
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:OH
Mailing Address - Zip Code:44146-3369
Mailing Address - Country:US
Mailing Address - Phone:216-533-9780
Mailing Address - Fax:
Practice Address - Street 1:4500 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44103-3736
Practice Address - Country:US
Practice Address - Phone:216-431-5800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-08
Last Update Date:2024-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator