| Doctor Name: | THERESA M FENOHR |
| NPI Number: | 1487089405 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | COA.14980NP |
| Business Practice Address: | 754 S Cleveland Ave #300 Mogadore, OH - 442602200 |
| Business Phone Number: | 3306282686 |
| Business Fax Number: | 3306280828 |
| Mailing Address: | 754 S Cleveland Ave, #300 MOGADORE |
| State: | OH |
| Postal Code: | 442602200 |
| Phone Number: | 3306282686 |
| Fax Number: | 3306280828 |
| NPI Enumeration Date: | 09/10/2013 |
| NPI Last Update Date: | 12/02/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | COA.14980NP |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |