MEDICARE: DAVINA DAWNIELL PELFREY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator		OH

General Provider Information

NPI Number	:	1558224394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVINA DAWNIELL PELFREY

Provider Business Mailing Address
First Line	:	2215 TUSCARAWAS ST E APT 216
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44707-2730
Country	:	US
Telephone Number	:	330-673-1347
Fax Number	:	330-676-3677

Provider Business Practice Location Address
First Line	:	2215 TUSCARAWAS ST E APT 216
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44707-2730
Country	:	US
Telephone Number	:	330-673-1347
Fax Number	:	330-676-3677

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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Directions to “ DAVINA DAWNIELL PELFREY ” Practice Location

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