Healthcare Provider Details

I. General information

NPI: 1932971280
Provider Name (Legal Business Name): LISA M DENNIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2023
Last Update Date: 02/03/2024
Certification Date: 02/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

454 COLE AVE
AKRON OH
44301-1963
US

IV. Provider business mailing address

454 COLE AVE
AKRON OH
44301-1963
US

V. Phone/Fax

Practice location:
  • Phone: 330-962-6622
  • Fax:
Mailing address:
  • Phone: 330-962-6622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: