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NPI Code Detail

MEDICARE: DACI STATLER

MEDICARE: DACI STATLER
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
1103K00000XBehavior AnalystCOBA.01896OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1801529557
Entity Type Code : Individual
Provider Name (Legal Business Name) : DACI STATLER
Provider Business Mailing Address
First Line : 11811 SHAKER BLVD STE 204
Second Line :
City : CLEVELAND
State : OH
Zip : 44120-1927
Country : US
Telephone Number : 216-499-3436
Fax Number : 815-581-1005
Provider Business Practice Location Address
First Line : 2293 VILLAGE PARK CT
Second Line :
City : ONTARIO
State : OH
Zip : 44906-1167
Country : US
Telephone Number : 216-499-3436
Fax Number : 815-581-1005
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2022
Last Update Date : 02/19/2026

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Directions to “ DACI STATLER ” Practice Location

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