Individual
CARI COST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1550 SHERIDAN DR STE 302, LANCASTER, OH 43130-1380
(740) 901-3049
Mailing address
1550 SHERIDAN DR STE 302, LANCASTER, OH 43130-1380
(740) 901-3049
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760108120
—
OH
Enumeration date
10/18/2022
Last updated
04/11/2023
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