Provider Demographics
NPI:1700047701
Name:RAFTER, ERIN MCDONOUGH (PHD)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:MCDONOUGH
Last Name:RAFTER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4641 FULTON RD. NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718
Mailing Address - Country:US
Mailing Address - Phone:330-433-6075
Mailing Address - Fax:330-433-1843
Practice Address - Street 1:4641 FULTON RD NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718
Practice Address - Country:US
Practice Address - Phone:330-433-6075
Practice Address - Fax:330-433-1843
Is Sole Proprietor?:No
Enumeration Date:2008-06-23
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6654103T00000X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor