Provider Demographics
NPI:1780406397
Name:CODY, CELESTE
Entity type:Individual
Prefix:
First Name:CELESTE
Middle Name:
Last Name:CODY
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 1:2555 KEMPER RD APT 105
Mailing Address - Street 2:
Mailing Address - City:SHAKER HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44120-1237
Mailing Address - Country:US
Mailing Address - Phone:216-254-2222
Mailing Address - Fax:
Practice Address - Street 1:16301 CHAGRIN BLVD APT 202
Practice Address - Street 2:
Practice Address - City:SHAKER HTS
Practice Address - State:OH
Practice Address - Zip Code:44120-3771
Practice Address - Country:US
Practice Address - Phone:678-603-9562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-26
Last Update Date:2024-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health