Individual
EDWARD M VANCISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CDCA
Contact information
Practice address
2902 PENNY LANE, AUSTINTOWN, OH 44515
(330) 564-3960
Mailing address
2902 PENNY LN, AUSTINTOWN, OH 44515-4943
(330) 564-3960
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA166799
OH
Other
Enumeration date
04/27/2018
Last updated
04/27/2018
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