Individual
JENNIFER WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PCC-S, LICDC
Contact information
Practice address
975 KINGSVIEW DR, LEBANON, OH 45036-9562
(513) 228-7800
(513) 228-7848
Mailing address
975 KINGSVIEW DR, SUITE 400, LEBANON, OH 45036-9562
(513) 228-7854
(513) 228-7848
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
975857
OH
101YP2500X
Professional Counselor
Primary
E-0003546-SUPV
OH
Other
Enumeration date
09/24/2008
Last updated
11/27/2013
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