Healthcare Provider Details

I. General information

NPI: 1376191833
Provider Name (Legal Business Name): NINA FRATTAROLI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2019
Last Update Date: 07/07/2023
Certification Date: 07/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 BELMONT AVE
YOUNGSTOWN OH
44505-2405
US

IV. Provider business mailing address

2401 BELMONT AVE
YOUNGSTOWN OH
44505-2405
US

V. Phone/Fax

Practice location:
  • Phone: 330-743-1015
  • Fax:
Mailing address:
  • Phone: 330-610-7129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberC.2305261
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: