Provider Demographics
NPI:1093282105
Name:PAUL, ALYSSA LYNN
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:LYNN
Last Name:PAUL
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 1:55 FIR HL APT 3C7
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44304-1533
Mailing Address - Country:US
Mailing Address - Phone:330-371-3478
Mailing Address - Fax:
Practice Address - Street 1:30 NORTHWEST AVE
Practice Address - Street 2:
Practice Address - City:TALLMADGE
Practice Address - State:OH
Practice Address - Zip Code:44278-1808
Practice Address - Country:US
Practice Address - Phone:330-633-4187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-26
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker