Individual
MARY K THEIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
40722 STATE ROUTE 154, LISBON, OH 44432-8500
(330) 424-9573
(330) 424-0877
Mailing address
219 QUINCY AVE, COLUMBIANA, OH 44408-1435
(330) 424-9573
(330) 424-0877
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
E0002685
OH
Other
Enumeration date
01/15/2007
Last updated
07/08/2007
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