Provider Demographics
NPI:1043040116
Name:SEPULVEDA, MARLENY (HHA)
Entity type:Individual
Prefix:
First Name:MARLENY
Middle Name:
Last Name:SEPULVEDA
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 W 150TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44135-3464
Mailing Address - Country:US
Mailing Address - Phone:216-855-6829
Mailing Address - Fax:
Practice Address - Street 1:4700 W 150TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44135-3464
Practice Address - Country:US
Practice Address - Phone:216-855-6829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No172A00000XOther Service ProvidersDriver
No174200000XOther Service ProvidersMeals