Individual
JABARI NAGILA ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PRS, CDCA, QMHS
Contact information
Practice address
3305 FULTON RD, CLEVELAND, OH 44109-1464
(914) 439-6065
Mailing address
3305 FULTON RD, CLEVELAND, OH 44109-1464
(914) 439-6065
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.128189
OH
Other
Enumeration date
11/13/2023
Last updated
04/29/2025
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