Healthcare Provider Details

I. General information

NPI: 1871967240
Provider Name (Legal Business Name): PAULA LEE DALLATORE LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PAULA LEE SMITH LPC

II. Dates (important events)

Enumeration Date: 11/22/2015
Last Update Date: 06/12/2023
Certification Date: 06/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 HOSPITAL DR
DOVER OH
44622-2058
US

IV. Provider business mailing address

835 MILLER AVE NW
NEW PHILADELPHIA OH
44663-1139
US

V. Phone/Fax

Practice location:
  • Phone: 330-343-6631
  • Fax: 330-343-8188
Mailing address:
  • Phone: 330-987-4479
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC.0500674
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.2303549
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: