Individual
MS. ETTA LOUISE CHARLEBOIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW-S
Contact information
Practice address
434 HOME STREET, GEORGETOWN, OH 45121-9321
(937) 378-2979
(937) 378-2970
Mailing address
15618 HILLCREST RD, MOUNT ORAB, OH 45154-8507
(513) 460-5191
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
I-0005459
OH
Other
Enumeration date
12/04/2007
Last updated
10/19/2018
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