Individual
JILL A WAITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC-S
Contact information
Practice address
33 S. LEXINGTON-SPRINGMILL ROAD, MANSFIELD, OH 44906
(419) 632-0588
Mailing address
P.O. BOX 102, ONTARIO, OH 44862
(419) 544-7001
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
E.0008093
OH
101YM0800X
Mental Health Counselor
Primary
E.0008093-SUPV
OH
Other
Enumeration date
11/30/2015
Last updated
03/13/2020
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