Individual
JENNIFER A STIMAC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CDCA
Contact information
Practice address
33157 BROOKCREST PL, AVON LAKE, OH 44012-3149
(440) 785-2106
Mailing address
33157 BROOKCREST PL, AVON LAKE, OH 44012-3149
(440) 785-2106
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
175T00000X
Peer Specialist
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CDCA.171856
LICENSE
OH
Enumeration date
11/12/2019
Last updated
11/25/2020
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