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General NPI Number Information
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NPI Number | 1194197772
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Entity Type | Individual
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Provider Name | CARA POLI
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Gender | Female
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Dates
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Enumeration Date | 10/22/2015
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Last Update Date | 10/22/2015
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Provider Practice Location Address
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Address Line | 3245 VESTAL RD
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City | YOUNGSTOWN
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State | OH
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Zip | 44509-1062
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Country | US
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Telephone | 330-793-9093
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Fax |
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Provider Business Mailing Address
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Address Line | 701 SHARON RD
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City | BEAVER
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State | PA
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Zip | 15009-3147
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT009120
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License Number State | OH
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