Provider Demographics
NPI:1811678386
Name:EASON, AYANNA R
Entity type:Individual
Prefix:MS
First Name:AYANNA
Middle Name:R
Last Name:EASON
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 1:1411 NW 14TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-1616
Mailing Address - Country:US
Mailing Address - Phone:305-325-1080
Mailing Address - Fax:
Practice Address - Street 1:1411 NW 14TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-1616
Practice Address - Country:US
Practice Address - Phone:305-325-1080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker