Individual
ITEN ELYASSAKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9415 MONTGOMERY RD STE G, MONTGOMERY, OH 45242-7641
(513) 377-1041
Mailing address
95 KENTUCKY DR UNIT 303, NEWPORT, KY 41071-1100
(513) 377-1041
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C.1902230
OH
Other
Enumeration date
05/09/2022
Last updated
05/09/2022
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