Healthcare Provider Details

I. General information

NPI: 1588579957
Provider Name (Legal Business Name): KAILEE R VILLA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1557 VERNON ODOM BLVD STE 200
AKRON OH
44320-4061
US

IV. Provider business mailing address

743 N PARK AVE
ALLIANCE OH
44601-1725
US

V. Phone/Fax

Practice location:
  • Phone: 234-334-1880
  • Fax:
Mailing address:
  • Phone: 330-937-0306
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberVD556435
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: