Individual
AMBER FANNIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
1865 N RIDGE RD E, LORAIN, OH 44055-3300
(440) 324-1300
Mailing address
1865 N RIDGE RD E, LORAIN, OH 44055-3300
(440) 324-1300
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S1904030
OH
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
07/02/2018
Last updated
03/29/2024
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