Individual
DENA E MCKILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CDCA
Contact information
Practice address
5414 HOMEGARDNER RD, CASTALIA, OH 44824-9420
(419) 871-2017
Mailing address
5414 HOMEGARDNER RD, CASTALIA, OH 44824-9420
(419) 871-2017
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
164853
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CDCA.164853
CHEMICAL DEPENDENCY PROFESSIONALS BOARD
OH
Enumeration date
07/06/2018
Last updated
07/06/2018
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