Provider Demographics
NPI:1730805953
Name:ALLEBACH, SAVANNAH NICOLE
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:NICOLE
Last Name:ALLEBACH
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 1:1062 S MUNROE RD
Mailing Address - Street 2:
Mailing Address - City:TALLMADGE
Mailing Address - State:OH
Mailing Address - Zip Code:44278-3336
Mailing Address - Country:US
Mailing Address - Phone:330-814-8950
Mailing Address - Fax:
Practice Address - Street 1:1062 S MUNROE RD
Practice Address - Street 2:
Practice Address - City:TALLMADGE
Practice Address - State:OH
Practice Address - Zip Code:44278-3336
Practice Address - Country:US
Practice Address - Phone:330-814-8950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker