Provider Demographics
NPI:1194428987
Name:CRABLE, TASHA N
Entity type:Individual
Prefix:
First Name:TASHA
Middle Name:N
Last Name:CRABLE
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 1:6083 OLD BRIDGE AVE NW
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-7884
Mailing Address - Country:US
Mailing Address - Phone:508-212-9252
Mailing Address - Fax:
Practice Address - Street 1:1744 HARVARD AVE NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44703-1316
Practice Address - Country:US
Practice Address - Phone:508-212-9252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide