Individual
CARMEN LOVELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3008 SUDBURY DR, KETTERING, OH 45420-1129
(937) 310-1269
Mailing address
3008 SUDBURY DR, KETTERING, OH 45420-1129
(937) 310-1269
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
179640
OH
Other
Enumeration date
11/13/2020
Last updated
02/16/2022
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