Healthcare Provider Details

I. General information

NPI: 1104033570
Provider Name (Legal Business Name): MRS. BARBARA A ALLISON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 CRACKEL RD
AURORA OH
44202-7700
US

IV. Provider business mailing address

10579 MARYLAND AVE
AURORA OH
44202-8509
US

V. Phone/Fax

Practice location:
  • Phone: 440-543-3498
  • Fax:
Mailing address:
  • Phone: 330-562-7016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number2661703
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: