MEDICARE: MRS. RACHEL PELOSI M.ED., P.C.

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	101YM0800X	Mental Health Counselor	C.0900001	OH

General Provider Information

NPI Number	:	1790107308
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RACHEL PELOSI M.ED., P.C.

Provider Business Mailing Address
First Line	:	2548 LISBURN CIR NW
Second Line	:
City	:	NORTH CANTON
State	:	OH
Zip	:	44720-8255
Country	:	US
Telephone Number	:	330-310-4398
Fax Number	:

Provider Business Practice Location Address
First Line	:	2548 LISBURN CIR NW
Second Line	:
City	:	NORTH CANTON
State	:	OH
Zip	:	44720
Country	:	US
Telephone Number	:	330-310-4398
Fax Number	:

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

Provider Enumeration Date	:	01/16/2014
Last Update Date	:	05/17/2018

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