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Individual
MISTY TOLLER
Active
Individual
MISTY TOLLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CDCA
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
162347
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
165911
OH
101YM0800X
Mental Health Counselor
QMHS
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0274663
—
OH
Enumeration date
11/14/2017
Last updated
01/23/2020
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