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Grayden Boyd Provance
Peer Specialist in Canton, Ohio
NPI 1730682410

Grayden Boyd Provance is a Peer Specialist based in Kent, OH. Grayden Boyd Provance practices in Canton, OH. The NPI Number for Grayden Boyd Provance is 1730682410 and holds a License No. 00495 (Ohio).

The current practice location address for Grayden Boyd Provance is 400 Tuscarawas St W, Canton, OH and can be reached out via phone at 330-438-2400 and via fax at 330-438-3003. You can also correspond with Grayden Boyd Provance through the mailing address at 5982 RHODES RD, KENT, OH - 44240-8100 (mailing address contact number: 330-673-1347).

Location: 400 Tuscarawas St W, Canton, OH, 44240-8100
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1730682410
Provider Name
Grayden Boyd Provance
Credential
Provider Entity Type
Individual
Gender
Male
Address
400 Tuscarawas St W, Canton, OH, 44240-8100
Phone Number
330-438-2400
Fax Number
330-438-3003
Provider Enumeration Date
03/09/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
400 Tuscarawas St W
City
Canton
State
Ohio
Zip
44702-2044
Phone Number
330-438-2400
Fax Number
330-438-3003
person
Provider Business Mailing Address Details
Address
5982 Rhodes Rd
City
Kent
State
Ohio
Zip
44240-8100
Phone Number
330-673-1347
Fax Number
330-678-3677
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
00495 (Ohio)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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