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Organization
MENTORING 1 ON 1
Active
Organization
MENTORING 1 ON 1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CRYSTAL WEAVER (OWNER)
(937) 718-1610
Entity
Organization
Contact information
Practice address
119 INDIANOLA AVE, DAYTON, OH 45405-3538
(937) 718-1610
Mailing address
119 INDIANOLA AVE, DAYTON, OH 45405-3538
(937) 718-1610
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/07/2023
Last updated
07/28/2025
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