Individual
MS. JADE T FISHBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
624 MARKET AVE N, CANTON, OH 44702-1017
(330) 493-4553
(330) 493-3761
Mailing address
624 MARKET AVE N, CANTON, OH 44702-1017
(330) 493-4553
(330) 493-3761
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C2406388
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCDCII.161524
OH
Other
Enumeration date
01/17/2014
Last updated
12/09/2024
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