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Individual

KAITLIN MARIE CANTRELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS/LPCC

Contact information

Practice address
59 N DIXIE DR STE C, VANDALIA, OH 45377-2067
(937) 314-1659
(937) 424-8767
Mailing address
1045 VAN ARDEN DR, VANDALIA, OH 45377-2922
(937) 305-6905

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
E.1700002
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0217668
OH
Enumeration date
04/19/2013
Last updated
06/01/2023
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