Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 60 252295 | NY |
Y | 207QA0401X | Family Doctor - Addiction Medicine | 34010211 | OH |
N | 207QA0401X | Family Doctor - Addiction Medicine | OS014921 | PA |
NPI | 1598908485 |
---|---|
Provider Name | Dr. Nicole Theresa Labor |
First Address | Akron, OH 44310-3110 |
Second Address | Akron, OH 44310-3110 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2009 |
Last Update Date | 20/11/2013 |