Individual
JENNA TISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDCA
Contact information
Practice address
62 E STEVENS ST, NEWARK, OH 43055-5969
(740) 366-7303
Mailing address
2502 N 4TH ST, COLUMBUS, OH 43202-2743
(541) 435-4211
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.175962
OH
Other
Enumeration date
03/11/2021
Last updated
03/11/2021
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