Individual
CHARITY A COUSIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPRS
Contact information
Practice address
25 N CANFIELD NILES RD STE 30, YOUNGSTOWN, OH 44515-2308
(330) 542-6200
(833) 307-1913
Mailing address
221 CRESCENT ST STE 202, WALTHAM, MA 02453-3425
(781) 487-1107
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
01/25/2023
Last updated
01/25/2023
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