Provider Demographics
NPI:1851099204
Name:SADLER, SHA'VAY LANIECE
Entity Type:Individual
Prefix:
First Name:SHA'VAY
Middle Name:LANIECE
Last Name:SADLER
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 1:747 CARNEGIE AVE APT C11
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44314-1180
Mailing Address - Country:US
Mailing Address - Phone:330-734-5961
Mailing Address - Fax:
Practice Address - Street 1:747 CARNEGIE AVE APT C11
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44314-1180
Practice Address - Country:US
Practice Address - Phone:330-734-5961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH376J00000X, 347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No376J00000XNursing Service Related ProvidersHomemaker