Healthcare Provider Details

I. General information

NPI: 1861161036
Provider Name (Legal Business Name): TARA FOUT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2021
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

656 CHERRY ST E
CANAL FULTON OH
44614-1251
US

IV. Provider business mailing address

656 CHERRY ST E
CANAL FULTON OH
44614-1251
US

V. Phone/Fax

Practice location:
  • Phone: 330-958-5838
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: