Healthcare Provider Details

I. General information

NPI: 1225823446
Provider Name (Legal Business Name): ALLISHA ANN MADISON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2025
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 GRAHAM ROAD CIR
STOW OH
44224-2901
US

IV. Provider business mailing address

1100 GRAHAM ROAD CIR
STOW OH
44224-2901
US

V. Phone/Fax

Practice location:
  • Phone: 330-928-0044
  • Fax: 330-928-0303
Mailing address:
  • Phone: 330-928-0044
  • Fax: 330-928-0303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: