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Active
Organization subpart
No

Provider details

NPI number
Authorized official
EMILY BRISBIN (OPERATIONS MANAGER)
(330) 552-8922
Entity
Organization

Contact information

Practice address
3480 W MARKET ST STE 205, FAIRLAWN, OH 44333-3369
(330) 552-8922
Mailing address
3480 W MARKET ST STE 205, FAIRLAWN, OH 44333-3369
(330) 552-8922

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
11/07/2024
Last updated
11/07/2024
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