Provider Demographics
NPI:1891591954
Name:STANFORD, DION
Entity type:Individual
Prefix:
First Name:DION
Middle Name:
Last Name:STANFORD
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 1:1374 HONODLE AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44305-2781
Mailing Address - Country:US
Mailing Address - Phone:678-857-2554
Mailing Address - Fax:
Practice Address - Street 1:1279 GLENVIEW ST
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-4702
Practice Address - Country:US
Practice Address - Phone:678-857-2554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care