Provider Demographics
NPI:1992273882
Name:HOOD, CHIQUETA L
Entity type:Individual
Prefix:
First Name:CHIQUETA
Middle Name:L
Last Name:HOOD
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 1:9907 ALEXANDER RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44125-2143
Mailing Address - Country:US
Mailing Address - Phone:216-441-4148
Mailing Address - Fax:
Practice Address - Street 1:9907 ALEXANDER RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44125-2143
Practice Address - Country:US
Practice Address - Phone:216-441-4148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-08
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH$$$$$$$$$Medicaid