Healthcare Provider Details

I. General information

NPI: 1427889617
Provider Name (Legal Business Name): MONICA LYNN CAMELI LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2024
Last Update Date: 08/09/2024
Certification Date: 08/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3680 STARRS CENTRE DR
CANFIELD OH
44406-9514
US

IV. Provider business mailing address

775 BROOKFIELD AVE
BOARDMAN OH
44512-4102
US

V. Phone/Fax

Practice location:
  • Phone: 330-518-0631
  • Fax:
Mailing address:
  • Phone: 330-518-0631
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number33.009023
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: