Individual
JERIA BROWN-WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
165 E PARK AVE, NILES, OH 44446-2352
(330) 544-8005
(330) 544-9379
Mailing address
2680 BLACK OAK DR, NILES, OH 44446-4469
(330) 360-2124
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C.2003066
OH
101YP2500X
Professional Counselor
C.2003066
OH
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
11/19/2018
Last updated
11/08/2023
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