Provider Demographics
NPI:1386380830
Name:BOATENG, RAHEAL
Entity type:Individual
Prefix:
First Name:RAHEAL
Middle Name:
Last Name:BOATENG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RAHEAL
Other - Middle Name:
Other - Last Name:BOATENG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1273 DERBYDALE RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44306-4039
Mailing Address - Country:US
Mailing Address - Phone:330-234-0636
Mailing Address - Fax:
Practice Address - Street 1:1273 DERBYDALE RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44306-4039
Practice Address - Country:US
Practice Address - Phone:330-234-0636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-09
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide