Healthcare Provider Details

I. General information

NPI: 1801418967
Provider Name (Legal Business Name): MEGAN JOANN VAJI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2020
Last Update Date: 05/12/2020
Certification Date: 05/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1580 DRIFTWOOD LN
MACEDONIA OH
44056-1460
US

IV. Provider business mailing address

1580 DRIFTWOOD LN
MACEDONIA OH
44056-1460
US

V. Phone/Fax

Practice location:
  • Phone: 330-322-3236
  • Fax:
Mailing address:
  • Phone: 330-322-3236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: