Healthcare Provider Details

I. General information

NPI: 1447176284
Provider Name (Legal Business Name): MELVA SUN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

396 WHITETAIL TRL NE
CANTON OH
44704-2490
US

IV. Provider business mailing address

396 WHITETAIL TRL NE
CANTON OH
44704-2490
US

V. Phone/Fax

Practice location:
  • Phone: 330-990-3920
  • Fax: 330-990-3920
Mailing address:
  • Phone: 330-990-3920
  • Fax: 330-990-3920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.1200879
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number33900382A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: