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NPI Code Detail

MEDICARE: LILLIAN VARDON ED.S.

MEDICARE: LILLIAN VARDON ED.S.
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
1103TS0200XSchool PsychologistKU1002895OH
2103TS0200XSchool PsychologistSP488OH

General Provider Information

NPI Number : 1538583844
Entity Type Code : Individual
Provider Name (Legal Business Name) : LILLIAN VARDON ED.S.
Provider Business Mailing Address
First Line : 65 STEINER AVE
Second Line :
City : AKRON
State : OH
Zip : 44301-1347
Country : US
Telephone Number : 330-761-3136
Fax Number :
Provider Business Practice Location Address
First Line : 65 STEINER AVE
Second Line :
City : AKRON
State : OH
Zip : 44301-1347
Country : US
Telephone Number : 330-761-3136
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2014
Last Update Date : 09/22/2014

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Directions to “ LILLIAN VARDON ED.S.” Practice Location

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