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General NPI Number Information
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NPI Number | 1750639811
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Entity Type | Individual
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Provider Name | KATE WECKERLY
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Gender | Female
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Dates
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Enumeration Date | 08/21/2012
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Last Update Date | 08/21/2012
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Provider Practice Location Address
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Address Line | 161 E MAIN ST
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City | RAVENNA
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State | OH
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Zip | 44266-3129
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Country | US
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Telephone | 330-296-2851
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Fax |
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Provider Business Mailing Address
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Address Line | 1536 MELOY RD
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City | KENT
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State | OH
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Zip | 44240-4665
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Country | US
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Telephone | 330-858-5149
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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 | 376J00000X
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Taxonomy Name | Homemaker
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License Number | TL202719
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License Number State | OH
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