Healthcare Provider Details

I. General information

NPI: 1043114390
Provider Name (Legal Business Name): ALAYSA SOLE FIELDS
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

1808 N WESTWOOD AVE APT C
TOLEDO OH
43607-1284
US

IV. Provider business mailing address

1808 N WESTWOOD AVE APT C
TOLEDO OH
43607-1284
US

V. Phone/Fax

Practice location:
  • Phone: 567-315-6192
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberUU211891
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: