Healthcare Provider Details

I. General information

NPI: 1033029871
Provider Name (Legal Business Name): RAEGAN FILIPOWICZ COUNSELOR TRAINEE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89 N MAIN ST
POLAND OH
44514-1693
US

IV. Provider business mailing address

89 N MAIN ST
POLAND OH
44514-1693
US

V. Phone/Fax

Practice location:
  • Phone: 330-770-4870
  • Fax: 330-426-0992
Mailing address:
  • Phone: 330-770-4870
  • Fax: 330-426-0992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberC.2608142-TRNE
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: