Individual
JENNA ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4429 FULTON DR NW, CANTON, OH 44718-2867
(330) 778-2919
Mailing address
6681 MAJOR WAY, HILLIARD, OH 43026-3427
(740) 680-1238
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C1500908
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2846675
—
OH
Enumeration date
05/20/2013
Last updated
06/01/2024
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