Individual
DEBRA LEE FUENTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC-SUPV, LICDC-CS
Contact information
Practice address
36 PUBLIC SQ, SUITE 202, WILLOUGHBY, OH 44094-7854
(440) 488-4081
Mailing address
36 PUBLIC SQ STE 105, WILLOUGHBY, OH 44094-7864
(440) 488-4081
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
031086
OH
101YP2500X
Professional Counselor
Primary
E8454-SUPV
OH
Other
Enumeration date
01/11/2012
Last updated
04/19/2023
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