Individual
MRS. IFEOMA E EZEPUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CDCA
Contact information
Practice address
5209 EUCLID AVE, CLEVELAND, OH 44103-3703
(216) 749-2246
Mailing address
20120 ARDWELL DR, EUCLID, OH 44123-1802
(216) 749-2246
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.172126
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CDCA.172126
CHEMICAL DEPENDENCY PROFESSIONALS BOARD
OH
Enumeration date
01/13/2020
Last updated
01/13/2020
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