Individual
ANNA STALLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
30 NORTHWEST AVE STE 120, TALLMADGE, OH 44278-1808
(330) 633-4187
Mailing address
1801 WATERMARK DR, COLUMBUS, OH 43215-7088
(614) 487-8758
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
172V00000X
Community Health Worker
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/25/2022
Last updated
06/02/2023
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