Provider Demographics
NPI:1235797572
Name:MAYLE, NICOLE JADE (BA)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:JADE
Last Name:MAYLE
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:829 HARRIET AVE NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44703
Mailing Address - Country:US
Mailing Address - Phone:330-356-6198
Mailing Address - Fax:
Practice Address - Street 1:829 HARRIET AVE NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44703
Practice Address - Country:US
Practice Address - Phone:330-356-6198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-02
Last Update Date:2025-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator