Provider Demographics
NPI:1306650007
Name:LEE, SHANIQUA SHATIA
Entity type:Individual
Prefix:
First Name:SHANIQUA
Middle Name:SHATIA
Last Name:LEE
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 1:185 STUBER ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44304-1252
Mailing Address - Country:US
Mailing Address - Phone:234-303-9577
Mailing Address - Fax:
Practice Address - Street 1:185 STUBER ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1252
Practice Address - Country:US
Practice Address - Phone:234-303-9577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-03
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide