Individual
ADAM DETTORRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
QMHS-BACH
Contact information
Practice address
2285 BENDEN DR, WOOSTER, OH 44691-2568
(330) 264-9029
Mailing address
2285 BENDEN DR, WOOSTER, OH 44691-2568
(330) 264-9029
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2615030
—
OH
Enumeration date
05/26/2022
Last updated
01/21/2026
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