Individual
JIBREEL N HAZLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1225 N MAIN ST, CANTON, OH 44720-1959
(330) 618-5246
Mailing address
1225 N MAIN ST, CANTON, OH 44720-1959
(330) 618-5246
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
—
OH
106S00000X
Behavior Technician
—
OH
251E00000X
Home Health Agency
—
OH
Other
Enumeration date
11/16/2020
Last updated
09/16/2025
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