Healthcare Provider Details

I. General information

NPI: 1730003203
Provider Name (Legal Business Name): LARA POLSTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4350 ALLEN RD
STOW OH
44224-1032
US

IV. Provider business mailing address

4350 ALLEN RD
STOW OH
44224-1032
US

V. Phone/Fax

Practice location:
  • Phone: 330-689-5430
  • Fax:
Mailing address:
  • Phone: 330-689-5430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number1589
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: