Provider Demographics
NPI:1760169940
Name:COPELAND, DASHAYLA T
Entity Type:Individual
Prefix:
First Name:DASHAYLA
Middle Name:T
Last Name:COPELAND
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 1:7182 TOMAHAWK TRL
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-5110
Mailing Address - Country:US
Mailing Address - Phone:614-886-9504
Mailing Address - Fax:
Practice Address - Street 1:7182 TOMAHAWK TRL
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-5110
Practice Address - Country:US
Practice Address - Phone:614-886-9504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty