Provider Demographics
NPI:1922699693
Name:MITCHELL, MERLAYNA MARIE
Entity Type:Individual
Prefix:
First Name:MERLAYNA
Middle Name:MARIE
Last Name:MITCHELL
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 1:4162 INDEPENDENCE CIR NW APT 6
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-7737
Mailing Address - Country:US
Mailing Address - Phone:330-904-9379
Mailing Address - Fax:
Practice Address - Street 1:400 TUSCARAWAS ST W
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44702-2044
Practice Address - Country:US
Practice Address - Phone:330-904-9379
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-26
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator