Healthcare Provider Details

I. General information

NPI: 1174825897
Provider Name (Legal Business Name): MEGAN NICOLE YARASCHUK PC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2010
Last Update Date: 12/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1984 COFFMAN RD STE D
NEWARK OH
43055-1013
US

IV. Provider business mailing address

1984 COFFMAN RD STE D
NEWARK OH
43055-1013
US

V. Phone/Fax

Practice location:
  • Phone: 740-349-7511
  • Fax:
Mailing address:
  • Phone: 740-349-7511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC080081
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: