Provider Demographics
NPI:1134310758
Name:OSWALD, CARLI DAWN
Entity Type:Individual
Prefix:MRS
First Name:CARLI
Middle Name:DAWN
Last Name:OSWALD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44302-1801
Mailing Address - Country:US
Mailing Address - Phone:330-762-0591
Mailing Address - Fax:330-762-2242
Practice Address - Street 1:87 N CANTON RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44305-3838
Practice Address - Country:US
Practice Address - Phone:330-733-7993
Practice Address - Fax:330-733-2242
Is Sole Proprietor?:No
Enumeration Date:2007-08-08
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC0700350101YP2500X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program