Provider Demographics
NPI:1114890357
Name:MAYLE, DEENA
Entity type:Individual
Prefix:
First Name:DEENA
Middle Name:
Last Name:MAYLE
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 1:1251 TRUMP AVE NE
Mailing Address - Street 2:
Mailing Address - City:EAST CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44730-1664
Mailing Address - Country:US
Mailing Address - Phone:330-605-2152
Mailing Address - Fax:
Practice Address - Street 1:1251 TRUMP AVE NE
Practice Address - Street 2:
Practice Address - City:EAST CANTON
Practice Address - State:OH
Practice Address - Zip Code:44730-1664
Practice Address - Country:US
Practice Address - Phone:330-605-2152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-24
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant