Individual
CHARLIE BANGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPCC-S
Contact information
Practice address
17405 HILLIARD RD, LAKEWOOD, OH 44107-5305
(216) 312-4774
Mailing address
17405 HILLIARD RD, LAKEWOOD, OH 44107
(216) 312-4774
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
E2133-S
OH
Other
Enumeration date
11/17/2014
Last updated
11/17/2014
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