Provider Demographics
NPI:1720305915
Name:TOZZI, TARA N (PSYD)
Entity Type:Individual
Prefix:DR
First Name:TARA
Middle Name:N
Last Name:TOZZI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:582 EASTON PLACE CIR
Mailing Address - Street 2:
Mailing Address - City:WADSWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44281-8070
Mailing Address - Country:US
Mailing Address - Phone:330-608-0410
Mailing Address - Fax:
Practice Address - Street 1:56 MILFORD DR STE 308
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-2767
Practice Address - Country:US
Practice Address - Phone:330-608-0410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-27
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004247103TC2200X
OH6778103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA4943902Medicaid