Healthcare Provider Details

I. General information

NPI: 1740625649
Provider Name (Legal Business Name): MARSHELL MCELROY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2013
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1742 ROOSEVELT AVE NE
CANTON OH
44705-2210
US

IV. Provider business mailing address

1742 ROOSEVELT AVE NE
CANTON OH
44705-2210
US

V. Phone/Fax

Practice location:
  • Phone: 330-481-3046
  • Fax:
Mailing address:
  • Phone: 380-209-5886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number322239431005
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: