Provider Demographics
NPI:1912532185
Name:BOONE-MAY, PORCHAE L
Entity Type:Individual
Prefix:
First Name:PORCHAE
Middle Name:L
Last Name:BOONE-MAY
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 1:902 FRIED ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-3712
Mailing Address - Country:US
Mailing Address - Phone:330-289-2553
Mailing Address - Fax:
Practice Address - Street 1:12 E EXCHANGE ST FL 6
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44308-1541
Practice Address - Country:US
Practice Address - Phone:330-289-2553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-09
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator