Individual
CARLA J GILENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PC
Contact information
Practice address
12557 RAVENWOOD DR, CHARDON, OH 44024-9009
(440) 285-3568
Mailing address
7396 AVON DR, MENTOR, OH 44060-5208
(440) 285-3568
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
C0500146
OH
Other
Enumeration date
11/30/2006
Last updated
07/08/2007
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