Provider Demographics
NPI:1770208027
Name:SALLEE, MARIANN LISA
Entity type:Individual
Prefix:
First Name:MARIANN
Middle Name:LISA
Last Name:SALLEE
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 1:940 AFTON AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-2460
Mailing Address - Country:US
Mailing Address - Phone:615-509-9699
Mailing Address - Fax:
Practice Address - Street 1:940 AFTON AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44512-2460
Practice Address - Country:US
Practice Address - Phone:615-509-9699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker