Healthcare Provider Details

I. General information

NPI: 1285570929
Provider Name (Legal Business Name): ALANNA MONAY THOMAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1759 SAWGRASS DR
GREEN OH
44685-7846
US

IV. Provider business mailing address

1759 SAWGRASS DR
GREEN OH
44685-7846
US

V. Phone/Fax

Practice location:
  • Phone: 330-780-3123
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: