Provider Demographics
NPI:1740176726
Name:STANZIANO, ISABELLA MARIE
Entity type:Individual
Prefix:
First Name:ISABELLA
Middle Name:MARIE
Last Name:STANZIANO
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 1:1239 FORD RD
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-1428
Mailing Address - Country:US
Mailing Address - Phone:234-380-3035
Mailing Address - Fax:
Practice Address - Street 1:4983 RIDGE RD
Practice Address - Street 2:
Practice Address - City:WADSWORTH
Practice Address - State:OH
Practice Address - Zip Code:44281-9738
Practice Address - Country:US
Practice Address - Phone:234-380-3035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2507128101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health