Individual
KIMBERLY WANOSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PCC
Contact information
Practice address
347 MIDWAY BLVD STE 200, ELYRIA, OH 44035-2496
(440) 324-5701
(440) 324-9978
Mailing address
347 MIDWAY BLVD STE 200, ELYRIA, OH 44035-2496
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
E.0700345
OH
Other
Enumeration date
03/14/2011
Last updated
02/22/2016
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