Individual
CYNTHIA JANE WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICDC
Contact information
Practice address
2458 STETZER RD, BUCYRUS, OH 44820-2066
(419) 562-2000
(419) 562-1296
Mailing address
PO BOX 765, BUCYRUS, OH 44820-0765
(419) 562-2000
(419) 562-1296
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
954357
OH
Other
Enumeration date
09/06/2006
Last updated
07/08/2007
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