Individual
CHEYANNE NICOLE CLOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDCA
Contact information
Practice address
11821 STATE ROUTE 160, VINTON, OH 45686-9009
(740) 245-3051
Mailing address
53 W MAIN ST, JACKSON, OH 45640-1180
(740) 577-6671
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
166820
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0145313
—
OH
Enumeration date
06/20/2018
Last updated
06/20/2018
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