Healthcare Provider Details

I. General information

NPI: 1639094600
Provider Name (Legal Business Name): AARON HART ED.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 LAWRENCE ST
MEDINA OH
44256-2809
US

IV. Provider business mailing address

825 LAWRENCE ST
MEDINA OH
44256-2809
US

V. Phone/Fax

Practice location:
  • Phone: 330-636-4006
  • Fax:
Mailing address:
  • Phone: 330-636-4006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberLSP.02329
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: