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Individual

JAMILA SHAFAWN HARDY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CDCA

Contact information

Practice address
1320 WASHINGTON BLVD, CLEVELAND, OH 44124
(216) 727-2086
Mailing address
1238 BROADWAY AVE, BEDFORD, OH 44146-4525
(216) 450-9557

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
165745
OH
175T00000X
Peer Specialist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
165745
OHIO BOARD OF COUNELORS
OH
Enumeration date
12/04/2017
Last updated
08/04/2018
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