Provider Demographics
NPI:1447021381
Name:VLAHOS-HALL, ELEANNA
Entity type:Individual
Prefix:
First Name:ELEANNA
Middle Name:
Last Name:VLAHOS-HALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3771 FAIRLAWN HEIGHTS DR SE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-2753
Mailing Address - Country:US
Mailing Address - Phone:330-720-2436
Mailing Address - Fax:
Practice Address - Street 1:3771 FAIRLAWN HEIGHTS DR SE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-2753
Practice Address - Country:US
Practice Address - Phone:330-720-2436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH3221214101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool