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General NPI Number Information
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NPI Number | 1194520148
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Entity Type | Individual
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Provider Name | DANIEL HAZLETT II MA
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Gender | Male
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Dates
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Enumeration Date | 02/14/2025
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Last Update Date | 02/14/2025
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Provider Practice Location Address
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Address Line | 3575 FOREST LAKE DR STE 100
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City | UNIONTOWN
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State | OH
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Zip | 44685-8115
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Country | US
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Telephone | 330-703-0105
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Fax | 234-294-5051
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Provider Business Mailing Address
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Address Line | 791 KENNEBEC AVE
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City | AKRON
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State | OH
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Zip | 44305-1133
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Country | US
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Telephone | 330-410-4165
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | M.2500355
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License Number State | OH
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