Individual
CONTESSA BUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
24200 CHAGRIN BLVD, BEACHWOOD, OH 44122-5550
(216) 831-6466
(216) 766-6084
Mailing address
13620 MAPLEROW AVE, GARFIELD HEIGHTS, OH 44105-6802
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
S1700279
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9166922
NEOHS PTAN
OH
Enumeration date
06/15/2017
Last updated
06/15/2017
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