Provider Demographics
NPI:1013801836
Name:WALKER-POLLACK, TARA (CASE MANAGER)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:
Last Name:WALKER-POLLACK
Suffix:
Gender:F
Credentials:CASE MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 E MIDLOTHIAN BLVD
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44507-2019
Mailing Address - Country:US
Mailing Address - Phone:330-234-5251
Mailing Address - Fax:330-234-5251
Practice Address - Street 1:80 E MIDLOTHIAN BLVD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44507-2019
Practice Address - Country:US
Practice Address - Phone:330-234-5251
Practice Address - Fax:330-234-5251
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty