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Individual

DIANE B WARGO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCDCIII

Contact information

Practice address
380 S PORTAGE PATH, AKRON, OH 44320-2326
(330) 315-4901
(330) 434-7885
Mailing address
838 COBURN ST, AKRON, OH 44311-1459
(330) 812-3118
(330) 208-2136

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCDCII.161785
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCDCIII162573
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0351895
OH
Enumeration date
05/24/2019
Last updated
10/19/2023
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