Individual
MS. SUSAN K WENTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PRS BA
Contact information
Practice address
246 NORTHLAND DR, MEDINA, OH 44256-3441
(440) 260-8300
Mailing address
434 EASTLAND RD, BEREA, OH 44017-1217
(440) 234-2006
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
164630
OH
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
11/08/2018
Last updated
09/26/2023
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