Healthcare Provider Details

I. General information

NPI: 1457270902
Provider Name (Legal Business Name): MICHELLE SIZEMORE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 E PARK AVE
NILES OH
44446-2352
US

IV. Provider business mailing address

4051 GLENWOOD AVE APT 32
BOARDMAN OH
44512-1045
US

V. Phone/Fax

Practice location:
  • Phone: 330-544-8005
  • Fax:
Mailing address:
  • Phone: 330-716-0460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: