Individual
MISS AUTUMN LEREE SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1672 DOMINION DR, AKRON, OH 44313
(330) 245-4281
Mailing address
1672 DOMINION DR, AKRON, OH 44313-5516
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
374U00000X
Home Health Aide
Primary
—
—
376J00000X
Homemaker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0332254
—
OH
Enumeration date
05/09/2019
Last updated
06/06/2019
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