Healthcare Provider Details

I. General information

NPI: 1699774968
Provider Name (Legal Business Name): KAREN T CIMINI PH.D., PSYCHOLOGIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3469 FORTUNA DR
AKRON OH
44312-5281
US

IV. Provider business mailing address

3469 FORTUNA DR
AKRON OH
44312-5281
US

V. Phone/Fax

Practice location:
  • Phone: 330-644-3469
  • Fax: 330-644-8519
Mailing address:
  • Phone: 330-644-3469
  • Fax: 330-644-8519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number4743
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: