MEDICARE: OPHIRA DAR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1043982465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OPHIRA DAR

Provider Business Mailing Address
First Line	:	2250 BARRINGTON RD
Second Line	:
City	:	UNIVERSITY HEIGHTS
State	:	OH
Zip	:	44118-3027
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8500 STATION ST
Second Line	:
City	:	MENTOR
State	:	OH
Zip	:	44060-4943
Country	:	US
Telephone Number	:	440-721-8979
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2021
Last Update Date	:	12/17/2023

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Directions to “ OPHIRA DAR ” Practice Location

Language	Start Address	Practice Location

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