Healthcare Provider Details

I. General information

NPI: 1043711583
Provider Name (Legal Business Name): HARLI RACHELLE BYELENE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2018
Last Update Date: 02/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14109 LOUISVILLE ST NE
PARIS OH
44669-9783
US

IV. Provider business mailing address

14109 LOUISVILLE ST NE
PARIS OH
44669-9783
US

V. Phone/Fax

Practice location:
  • Phone: 330-862-2097
  • Fax:
Mailing address:
  • Phone: 330-862-2097
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: