Individual
MS. MARJORIE WING KAVANAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
2425 MALLARD LN., #3, BEAVERCREEK, OH 45431-3678
(937) 427-2427
Mailing address
2425 MALLARD LN., #3, BEAVERCREEK, OH 45431-3678
(937) 427-2427
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C0004614
OH
Other
Enumeration date
07/30/2015
Last updated
07/30/2015
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