Individual
ELYSE NICOLE ETAPA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.C.C.
Contact information
Practice address
7110 WHIPPLE AVE NW, SUITE C-106, NORTH CANTON, OH 44720-7154
(330) 703-6578
(330) 703-6578
Mailing address
7110 WHIPPLE AVE NW, SUITE C-106, NORTH CANTON, OH 44720-7154
(330) 703-6578
(330) 703-6578
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C0900340
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
57484
—
OH
Enumeration date
10/13/2010
Last updated
06/27/2014
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