Individual
BETTY FANNIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CDCA
Contact information
Practice address
411 COURT ST, PORTSMOUTH, OH 45662-3932
(740) 354-6685
Mailing address
923 FINDLAY ST, PORTSMOUTH, OH 45662-4148
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
111423
OH
101YM0800X
Mental Health Counselor
QMHS
OH
171M00000X
Case Manager/Care Coordinator
CMS
OH
Other
Enumeration date
11/16/2017
Last updated
11/29/2018
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