Healthcare Provider Details

I. General information

NPI: 1619805728
Provider Name (Legal Business Name): ALEESHA MARIE PONGRATZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

558 E BUCHTEL AVE UNIT 1
AKRON OH
44304-1945
US

IV. Provider business mailing address

558 E BUCHTEL AVE UNIT 1
AKRON OH
44304-1945
US

V. Phone/Fax

Practice location:
  • Phone: 330-243-5465
  • Fax:
Mailing address:
  • Phone: 330-243-5465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number603113691225
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: