Provider Demographics
NPI:1215625223
Name:RASEY, BETH ANN (OCPS)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:ANN
Last Name:RASEY
Suffix:
Gender:F
Credentials:OCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 WHITE POND DR STE 300
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-4211
Mailing Address - Country:US
Mailing Address - Phone:330-864-1359
Mailing Address - Fax:
Practice Address - Street 1:460 WHITE POND DR STE 300
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-4211
Practice Address - Country:US
Practice Address - Phone:330-864-1359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-27
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
376J00000X
OHOCPS.0873405300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes405300000XOther Service ProvidersPrevention Professional
No376J00000XNursing Service Related ProvidersHomemaker