Individual
ANGELA M PAUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICDC
Contact information
Practice address
1341 MARKET AVE N, CANTON, OH 44714-2605
(330) 453-8252
(330) 452-4655
Mailing address
625 CLEVELAND AVE NW, CANTON, OH 44702-1805
(330) 455-0374
(330) 453-6716
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LICDC161720
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0270300
—
OH
Enumeration date
02/17/2016
Last updated
06/15/2020
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