Individual
MRS. CAROLYN D MASSENGALE -HASAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
171M00000X
Contact information
Practice address
1400 E 55TH ST, CLEVELAND, OH 44103-1304
(216) 369-8550
Mailing address
1400 E 55TH ST, CLEVELAND, OH 44103-1304
(216) 369-8550
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
190703
OH
Other
Enumeration date
11/14/2017
Last updated
12/20/2024
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