Provider Demographics
NPI:1700804150
Name:DALPE, PAULINE THERESE (MS OF ED)
Entity Type:Individual
Prefix:MS
First Name:PAULINE
Middle Name:THERESE
Last Name:DALPE
Suffix:
Gender:F
Credentials:MS OF ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4250 SHIELDS RD
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-9329
Mailing Address - Country:US
Mailing Address - Phone:330-792-7636
Mailing Address - Fax:
Practice Address - Street 1:2401 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-2405
Practice Address - Country:US
Practice Address - Phone:330-744-3320
Practice Address - Fax:330-744-3677
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC-0005883101Y00000X, 101YM0800X, 101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000124298OtherANTHEM PROVIDER ID