Individual
ANNA IRIS LILLIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CDCA
Contact information
Practice address
1909 E 89TH ST, CLEVELAND, OH 44106-2007
(216) 231-3772
(216) 231-5040
Mailing address
1909 E 89TH ST, CLEVELAND, OH 44106-2007
(216) 231-3772
(216) 231-5040
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
140521
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
346579390
—
OH
Enumeration date
11/29/2017
Last updated
02/14/2019
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