Provider Demographics
NPI:1467883751
Name:COIA, STAR CAROLYN MARIE
Entity Type:Individual
Prefix:
First Name:STAR
Middle Name:CAROLYN MARIE
Last Name:COIA
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 1:1113 N MAIN ST APT 70
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-1985
Mailing Address - Country:US
Mailing Address - Phone:330-933-3737
Mailing Address - Fax:
Practice Address - Street 1:1113 N MAIN ST APT 70
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-1985
Practice Address - Country:US
Practice Address - Phone:330-933-3737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-11
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker