Individual
FADIA JALLAQ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4558 HIRTH HILL RD E, GROVE CITY, OH 43123-4512
(513) 725-3457
Mailing address
4558 HIRTH HILL RD E, GROVE CITY, OH 43123-4512
(614) 965-1422
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
C.2204770
OH
101YP2500X
Professional Counselor
2103678
OH
101YP2500X
Professional Counselor
Primary
C.2204770
OH
106S00000X
Behavior Technician
—
OH
Other
Enumeration date
02/28/2017
Last updated
09/22/2023
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