Individual
REBECCA VITALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
305 MCKINLEY AVE NW, CANTON, OH 44702-1717
(330) 438-2500
Mailing address
305 MCKINLEY AVE NW, CANTON, OH 44702-1717
(330) 438-2550
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
UA1017408
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
UA1017408
OHIO DEPARTMENT OF EDUCATION
OH
Enumeration date
04/23/2014
Last updated
04/23/2014
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