Provider Demographics
NPI:1982264941
Name:MAYO, SHARAYA MONIQUE
Entity type:Individual
Prefix:
First Name:SHARAYA
Middle Name:MONIQUE
Last Name:MAYO
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 1:2917 VIENNA VIEW CT SW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44706-5630
Mailing Address - Country:US
Mailing Address - Phone:330-617-9332
Mailing Address - Fax:
Practice Address - Street 1:2917 VIENNA VIEW CT SW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44706-5630
Practice Address - Country:US
Practice Address - Phone:330-617-9332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-20
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401484610213376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker