Provider Demographics
NPI:1972338192
Name:HOLCOMB, NAIZELLE
Entity type:Individual
Prefix:
First Name:NAIZELLE
Middle Name:
Last Name:HOLCOMB
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 FAIRMOUNT BLVD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44106-3100
Mailing Address - Country:US
Mailing Address - Phone:216-612-6038
Mailing Address - Fax:
Practice Address - Street 1:2450 FAIRMOUNT BLVD
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44106-3100
Practice Address - Country:US
Practice Address - Phone:216-612-6038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator