Individual
ANGELLA RICHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CDCA
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
APS.003787
OH
324500000X
Substance Abuse Rehabilitation Facility
182574
OH
405300000X
Prevention Professional
182574
OH
Other
Enumeration date
02/23/2023
Last updated
10/03/2023
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