Individual
ANGELETTA L FAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
813 BRYDEN RD, COLUMBUS, OH 43205-1759
(614) 392-7253
Mailing address
6161 BUSCH BLVD STE 290, COLUMBUS, OH 43229-2587
(614) 987-5003
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.180148
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
474422489
—
OH
Enumeration date
04/01/2022
Last updated
04/01/2024
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