Provider Demographics
NPI:1497507776
Name:DEAN, DEASIA LEE
Entity Type:Individual
Prefix:MS
First Name:DEASIA
Middle Name:LEE
Last Name:DEAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 EAST AVE APT 501
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-5758
Mailing Address - Country:US
Mailing Address - Phone:440-989-6290
Mailing Address - Fax:
Practice Address - Street 1:310 EAST AVE APT 501
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-5758
Practice Address - Country:US
Practice Address - Phone:440-989-6290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide