Individual
BLYTHE KAYLA ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDCA
Contact information
Practice address
1 ELIZABETH PL, DAYTON, OH 45417-3445
(937) 813-1737
Mailing address
1 ELIZABETH PL, DAYTON, OH 45417-3445
(937) 813-1737
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
168755
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.165292
OH
Other
Enumeration date
07/09/2018
Last updated
12/14/2018
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