Provider Information for 1215468335
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KIRA L KARABANOVS LISW-S
Sex: Female
NPI: 1215468335
Last Updated: 2020-03-05
Certification Date: 2020-03-05
Certification Date: 2020-03-05
Details
| Name | Value | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1215468335 | ||||||||||||||
| Enumeration Date | 2017-03-21 | ||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||
| Sole Proprietor | YES | ||||||||||||||
| Status | Active | ||||||||||||||
| Mailing Address | 6090 MIDDLEBROOK BLVD BROOKPARK, OH 44142-3220 United States Phone: 216-470-7025 | Fax: | ||||||||||||||
| Primary Practice Address | 21430 LORAIN RD STE 110 CLEVELAND, OH 44126-2148 United States Phone: 216-302-4309 | Fax: | ||||||||||||||
| Secondary Practice Address(es) | 434 EASTLAND RD | ||||||||||||||
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