Provider Demographics
NPI:1124504964
Name:WINFORD, DEYMONNE KRISTOPHER
Entity type:Individual
Prefix:
First Name:DEYMONNE
Middle Name:KRISTOPHER
Last Name:WINFORD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2359 KNOLLWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44514-1525
Mailing Address - Country:US
Mailing Address - Phone:216-260-1405
Mailing Address - Fax:330-632-8823
Practice Address - Street 1:50 ESSEX ST
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44502-1838
Practice Address - Country:US
Practice Address - Phone:216-260-1405
Practice Address - Fax:330-632-8823
Is Sole Proprietor?:No
Enumeration Date:2018-07-16
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician