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General NPI Number Information
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NPI Number | 1912491036
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Entity Type | Individual
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Provider Name | TARA FLAKES MFTT BA
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Gender | Female
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Dates
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Enumeration Date | 06/21/2018
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 401 TUSCARAWAS ST W STE 501
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City | CANTON
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State | OH
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Zip | 44702-2045
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Country | US
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Telephone | 440-260-8300
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Fax |
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Provider Business Mailing Address
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Address Line | 101 PEMBROKE CT
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City | GREENSBURG
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State | PA
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Zip | 15601-6404
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Country | US
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Telephone | 724-396-1510
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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 |
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License Number State |
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