Provider Demographics
NPI:1275339194
Name:CODY, MALENA
Entity type:Individual
Prefix:
First Name:MALENA
Middle Name:
Last Name:CODY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1332 WEATHERVANE LN APT 1C
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-5132
Mailing Address - Country:US
Mailing Address - Phone:442-347-5103
Mailing Address - Fax:
Practice Address - Street 1:1630 SCHILLER AVE
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44223-1756
Practice Address - Country:US
Practice Address - Phone:330-807-5251
Practice Address - Fax:330-319-7636
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.027357225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist