Provider Demographics
NPI:1528535259
Name:MASSIELLO, ANA (AUD)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:MASSIELLO
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7227 GLENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-4853
Mailing Address - Country:US
Mailing Address - Phone:330-629-2144
Mailing Address - Fax:
Practice Address - Street 1:7227 GLENWOOD AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44512
Practice Address - Country:US
Practice Address - Phone:330-629-2144
Practice Address - Fax:330-629-2140
Is Sole Proprietor?:No
Enumeration Date:2018-10-31
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA.02154231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist