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NPI Code Detail

MEDICARE: RANDI S MOTZ

MEDICARE: RANDI S MOTZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorE-0001117OH

General Provider Information

NPI Number : 1356443212
Entity Type Code : Individual
Provider Name (Legal Business Name) : RANDI S MOTZ
Provider Business Mailing Address
First Line : 2226 HARVARD AVE NW
Second Line :
City : CANTON
State : OH
Zip : 44709-3947
Country : US
Telephone Number : 330-452-2320
Fax Number :
Provider Business Practice Location Address
First Line : 919 2ND ST NE
Second Line :
City : CANTON
State : OH
Zip : 44704-1132
Country : US
Telephone Number : 330-454-7917
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2006
Last Update Date : 07/08/2007

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Directions to “ RANDI S MOTZ ” Practice Location

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