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Individual

CORLISS WEST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1 N COMMERCE PARK DR STE 318, CINCINNATI, OH 45215-3187
(513) 761-0158
Mailing address
1 N COMMERCE PARK DR STE 318, CINCINNATI, OH 45215-3187
(513) 761-0158

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA.110131
OH
376J00000X
Homemaker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0143878
OH
Enumeration date
09/21/2016
Last updated
03/14/2022
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