Healthcare Provider Details

I. General information

NPI: 1891881082
Provider Name (Legal Business Name): KATIE MARY KATHERINE CURTIS P.C./C.R.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 CLEVELAND AVE NW SUITE 300
CANTON OH
44702-1700
US

IV. Provider business mailing address

636 PORTAGE LAKES DR
AKRON OH
44319-2208
US

V. Phone/Fax

Practice location:
  • Phone: 330-454-7066
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC 0500008
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: