Healthcare Provider Details

I. General information

NPI: 1164784872
Provider Name (Legal Business Name): MICHELLE ESCALAMBRE ECE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2012
Last Update Date: 06/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 LOCUST ST
AKRON OH
44302-1801
US

IV. Provider business mailing address

87 N CANTON RD
AKRON OH
44305-3838
US

V. Phone/Fax

Practice location:
  • Phone: 330-762-0591
  • Fax: 330-762-2242
Mailing address:
  • Phone: 330-794-4254
  • Fax: 330-794-4262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: