Provider Demographics
NPI:1871337337
Name:DOVE, ROSLYN
Entity type:Individual
Prefix:
First Name:ROSLYN
Middle Name:
Last Name:DOVE
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 1:17325 EUCLID AVE STE 2040
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44112-1250
Mailing Address - Country:US
Mailing Address - Phone:567-416-9997
Mailing Address - Fax:
Practice Address - Street 1:17325 EUCLID AVE STE 2040
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44112-1250
Practice Address - Country:US
Practice Address - Phone:567-416-9997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator