Individual
AVA BOESEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CDCA
Contact information
Practice address
2115 W PARK DR, LORAIN, OH 44053-1138
(440) 989-4987
(440) 246-0189
Mailing address
2115 W PARK DR, LORAIN, OH 44053-1138
(440) 989-4987
(440) 246-0189
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.150144
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CDCA.150144
LICENSE
OH
Enumeration date
03/28/2017
Last updated
03/28/2017
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