Provider Demographics
NPI:1841908316
Name:HENLEY, SANYA M (MED)
Entity type:Individual
Prefix:
First Name:SANYA
Middle Name:M
Last Name:HENLEY
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6955 LIBERTY RD
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-5005
Mailing Address - Country:US
Mailing Address - Phone:330-293-1981
Mailing Address - Fax:
Practice Address - Street 1:6955 LIBERTY RD
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-5005
Practice Address - Country:US
Practice Address - Phone:330-293-1981
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant