Provider Demographics
NPI:1912530908
Name:SLAYTON-TWITTY, MONICA
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:SLAYTON-TWITTY
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 1:2493 EAST AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44314-1859
Mailing Address - Country:US
Mailing Address - Phone:330-766-4281
Mailing Address - Fax:
Practice Address - Street 1:2493 EAST AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44314-1859
Practice Address - Country:US
Practice Address - Phone:330-766-4281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-18
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0271776374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0271776Medicaid