Healthcare Provider Details

I. General information

NPI: 1083537476
Provider Name (Legal Business Name): AMARIA LYNN ERVIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

635 MERCER AVE NE
WARREN OH
44483-4907
US

IV. Provider business mailing address

635 MERCER AVE NE
WARREN OH
44483-4907
US

V. Phone/Fax

Practice location:
  • Phone: 330-317-0673
  • Fax:
Mailing address:
  • Phone: 330-317-0673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: