Individual
ISIS MYSTIQUE DOUGLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
720 TREESIDE DR, AKRON, OH 44313-5667
(330) 245-7431
Mailing address
720 TREESIDE DR, AKRON, OH 44313-5667
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN.175394.MEDS-IV
OH
Other
Enumeration date
11/18/2025
Last updated
11/18/2025
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