Provider Demographics
NPI:1609076769
Name:TABBARA, PATRICIA (MSED,LPCC-S)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:TABBARA
Suffix:
Gender:F
Credentials:MSED,LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:758 ARDMORE AVE
Mailing Address - Street 2:FLOOR 1
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44302-1210
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:155 N WATER ST
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-2418
Practice Address - Country:US
Practice Address - Phone:330-678-3006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0002159101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health