Healthcare Provider Details

I. General information

NPI: 1780266114
Provider Name (Legal Business Name): SARA TOKARSKY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2021
Last Update Date: 04/26/2021
Certification Date: 04/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 WINDHAM CT
BOARDMAN OH
44512-5083
US

IV. Provider business mailing address

53 ROMAINE AVE
BOARDMAN OH
44512-3302
US

V. Phone/Fax

Practice location:
  • Phone: 330-629-2955
  • Fax:
Mailing address:
  • Phone: 330-518-8469
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: