Individual
SUMMER GROOMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CDCA
Contact information
Practice address
408 COSHOCTON AVE, MOUNT VERNON, OH 43050-2634
(740) 326-1382
Mailing address
408 COSHOCTON AVE, MOUNT VERNON, OH 43050-2634
(740) 326-1382
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
179328
OH
Other
Enumeration date
09/30/2022
Last updated
10/23/2022
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