MEDICARE: DE-SHAWNAY BETTIEANA-TANIESHA DANIELS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	373H00000X	Day Training/Habilitation Specialist		OH

General Provider Information

NPI Number	:	1710680178
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DE-SHAWNAY BETTIEANA-TANIESHA DANIELS

Provider Business Mailing Address
First Line	:	1613 2ND ST NE
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44704-1705
Country	:	US
Telephone Number	:	330-371-8985
Fax Number	:

Provider Business Practice Location Address
First Line	:	1613 2ND ST NE
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44704-1705
Country	:	US
Telephone Number	:	330-371-8985
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2023
Last Update Date	:	03/24/2023

Similar Medicare Providers

1174831218 — CANTON PHYSICAL MEDICARE, LLC
Practice Location Address:

2050 CUMMING HWY , SUITE 100
CANTON, GA
30114-8614

Practice Phone: 770-345-9600
Practice Fax:

1669421434 — BROOKE HANAWAY LEWIS MD
Practice Location Address:

134 RIVERSTONE TER STE 202
CANTON, GA
30114-1705

Practice Phone: 770-213-8942
Practice Fax: 770-213-4158

1619938198 — NERKA LAVETTE WATKINS-GRAHAM MD
Practice Location Address:

134 RIVERSTONE TERRACE , SUITE 103
CANTON, GA
30114-1705

Practice Phone: 770-479-1985
Practice Fax: 770-479-4839

1073574554 — JONATHAN ARTHUR CHEEK MD
Practice Location Address:

134 RIVERSTONE TERRACE , SUITE 103
CANTON, GA
30114-1705

Practice Phone: 770-479-1985
Practice Fax: 770-479-4839

1295690667 — ASHLEY BURTON
Practice Location Address:

134 RIVERSTONE TER STE 103
CANTON, GA
30114-1705

Practice Phone: 770-479-1985
Practice Fax:

1679669493 — THELMA COSS
Practice Location Address:

919 2ND ST NE
CANTON, OH
44704-1132

Practice Phone: 330-454-7917
Practice Fax:

Directions to “ DE-SHAWNAY BETTIEANA-TANIESHA DANIELS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.