Provider Demographics
NPI:1770301194
Name:ISAIAH, MARY A
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:A
Last Name:ISAIAH
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 1:2510 WEALTHY DR
Mailing Address - Street 2:
Mailing Address - City:COPLEY
Mailing Address - State:OH
Mailing Address - Zip Code:44321-2341
Mailing Address - Country:US
Mailing Address - Phone:330-812-1828
Mailing Address - Fax:
Practice Address - Street 1:1557 VERNON ODOM BLVD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-4061
Practice Address - Country:US
Practice Address - Phone:234-334-1880
Practice Address - Fax:877-569-6002
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-03
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator