Healthcare Provider Details

I. General information

NPI: 1073434650
Provider Name (Legal Business Name): ALISA MARIE STANLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7511 COUNTY ROAD 37
MANSFIELD OH
44904-9696
US

IV. Provider business mailing address

7511 COUNTY ROAD 37
MANSFIELD OH
44904-9696
US

V. Phone/Fax

Practice location:
  • Phone: 419-370-9844
  • Fax:
Mailing address:
  • Phone: 419-370-9844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: