Individual
AVERY SUMPTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4891 E COUNTY LINE RD, MINERAL RIDGE, OH 44440-9411
(740) 564-8768
Mailing address
DEPT 781625 PO BOX 78000, DETROIT, MI 48278-1625
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C.2405754-TRNE
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1473276
—
OH
Enumeration date
01/08/2019
Last updated
08/21/2024
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