Doctor Name: | CRISSY ANN KOLARIK |
NPI Number: | 1053582395 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | E0002700 |
Business Practice Address: | 3490 Ridgewood Rd Fairlawn, OH - 443333120 |
Business Phone Number: | 3306651811 |
Business Fax Number: | |
Mailing Address: | 3490 Ridgewood Rd, FAIRLAWN |
State: | OH |
Postal Code: | 443333120 |
Phone Number: | 3306651811 |
Fax Number: | |
NPI Enumeration Date: | 03/14/2008 |
NPI Last Update Date: | 03/14/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | E0002700 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |