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General NPI Number Information
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NPI Number | 1336402015
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Entity Type | Individual
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Provider Name | CAROL AMELIA KAVULIC PC
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Gender | Female
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Dates
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Enumeration Date | 06/19/2012
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Last Update Date | 06/19/2012
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Provider Practice Location Address
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Address Line | 202 E BAGLEY RD
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City | BEREA
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State | OH
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Zip | 44017-2058
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Country | US
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Telephone | 440-234-2006
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Fax |
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Provider Business Mailing Address
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Address Line | 1390 KENNEDY BLVD APT. 205
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City | CUYAHOGA FALLS
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State | OH
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Zip | 44221-5359
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Country | US
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Telephone | 216-534-5446
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | C.0900181
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License Number State | OH
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