Provider Demographics
NPI:1780045989
Name:IANNI, MELANIE
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:IANNI
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 1:2228 6TH ST SW
Mailing Address - Street 2:1
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44314-2409
Mailing Address - Country:US
Mailing Address - Phone:216-346-4101
Mailing Address - Fax:
Practice Address - Street 1:310 BENNETT AVE
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-3211
Practice Address - Country:US
Practice Address - Phone:330-839-9966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-15
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1000043104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker