Healthcare Provider Details

I. General information

NPI: 1992494983
Provider Name (Legal Business Name): ANTON AMIR MAYS MA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ANTON AMIR MAYS MA

II. Dates (important events)

Enumeration Date: 05/04/2023
Last Update Date: 06/29/2023
Certification Date: 06/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 ALBERT SABIN WAY
CINCINNATI OH
45229-2838
US

IV. Provider business mailing address

437 W 6TH ST APT 203
COVINGTON KY
41011-1386
US

V. Phone/Fax

Practice location:
  • Phone: 513-558-5801
  • Fax:
Mailing address:
  • Phone: 586-215-6370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: