Provider Demographics
NPI:1285216762
Name:WILLIAMS, ROBYN ROCHELLE (CEO)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:ROCHELLE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CEO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1185 JASON AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44314-2535
Mailing Address - Country:US
Mailing Address - Phone:330-754-1362
Mailing Address - Fax:330-473-4434
Practice Address - Street 1:1185 JASON AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44314-2535
Practice Address - Country:US
Practice Address - Phone:330-754-1362
Practice Address - Fax:330-473-4434
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-24
Last Update Date:2021-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0426599Medicaid