Individual
BEATRICE DE LA PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CDCA
Contact information
Practice address
2202 PRAME AVE., CLEVELAND, OH 44109
(216) 459-1222
(216) 459-2696
Mailing address
137 NOTRE DAME CIRCLE, ELYRIA, OH 44035
(440) 406-7495
(440) 246-0189
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.141534
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CDCA.141534
LICENSE
OH
Enumeration date
11/28/2017
Last updated
06/13/2018
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