Individual
SHELLY RENEE STAFFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
STNA
Contact information
Practice address
4657 17TH ST NW, CANTON, OH 44708-2713
(330) 312-9920
Mailing address
4657 17TH ST NW, CANTON, OH 44708-2713
(330) 312-9920
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
400687791107
OH
Other
Enumeration date
03/22/2018
Last updated
03/22/2018
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