Individual
MOLLY E SHOUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
104 SPINK ST, WOOSTER, OH 44691-3652
(330) 264-8498
Mailing address
104 SPINK ST, WOOSTER, OH 44691-3652
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
07/19/2021
Last updated
12/21/2023
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