Individual
LEON D WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1043 GARDENVIEW ST, KENT, OH 44240-3369
(330) 227-4858
Mailing address
1043 GARDENVIEW ST, KENT, OH 44240-3369
(330) 227-4858
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
172A00000X
Driver
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6705758
DEPARTMENT OF OHIO DEVELOPMENTAL DISABILITIES
OH
Enumeration date
12/28/2020
Last updated
01/02/2021
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