Provider Demographics
NPI:1659247633
Name:MAYLE, LATOYIA
Entity type:Individual
Prefix:
First Name:LATOYIA
Middle Name:
Last Name:MAYLE
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 1:253 LINWOOD AVE NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708-5622
Mailing Address - Country:US
Mailing Address - Phone:716-421-0707
Mailing Address - Fax:
Practice Address - Street 1:253 LINWOOD AVE NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-5622
Practice Address - Country:US
Practice Address - Phone:716-421-0707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-15
Last Update Date:2025-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH174200000X, 253Z00000X, 347C00000X, 172A00000X, 347E00000X, 343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No174200000XOther Service ProvidersMeals
No253Z00000XAgenciesIn Home Supportive Care
No347C00000XTransportation ServicesPrivate Vehicle
No172A00000XOther Service ProvidersDriver
No347E00000XTransportation ServicesTransportation Broker