Individual
JOHNNY ILIJEVSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
QMHS
Contact information
Practice address
6662 STATE ROUTE 43, KENT, OH 44240-6137
(330) 956-7182
Mailing address
6662 STATE ROUTE 43, KENT, OH 44240-6137
(330) 956-7182
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/09/2018
Last updated
07/09/2018
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