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Individual

MR. DALE KIDD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CDCA

Contact information

Practice address
6753 STATE RD, PARMA, OH 44134-4517
(440) 843-5530
(440) 843-1627
Mailing address
6753 STATE RD, PARMA, OH 44134-4517
(440) 843-5530
(440) 843-1627

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
070337
OH

Other

Enumeration date
07/20/2015
Last updated
07/20/2015
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