Individual
STEPHANIE VANGORDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4726 MAIN AVE, ASHTABULA, OH 44004-6929
(440) 578-8200
Mailing address
7232 JUSTIN WAY, MENTOR, OH 44060-4881
(440) 578-8200
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C.2204388-TRNE
OH
104100000X
Social Worker
C.2204388-TRNE
OH
Other
Enumeration date
01/30/2023
Last updated
05/11/2023
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