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General NPI Number Information
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NPI Number | 1972179331
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Entity Type | Individual
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Provider Name | MS. IRENE MARY HARGRAVE
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Gender | Female
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Dates
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Enumeration Date | 05/27/2021
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Last Update Date | 11/01/2023
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Provider Practice Location Address
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Address Line | 238 S. MERIDIAN RD.
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City | YOUNGSTOWN
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State | OH
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Zip | 44509
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Country | US
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Telephone | 330-318-3416
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Fax | 330-856-5839
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Provider Business Mailing Address
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Address Line | 1702 CRANBERRY LANE N.E. APT 159
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City | WARREN
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State | OH
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Zip | 44483
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Country | US
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Telephone | 330-766-5736
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Fax | 330-856-5839
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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