Individual
JENNA POLING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCDCII
Contact information
Practice address
104 N MAIN ST, MARYSVILLE, OH 43040-1106
(937) 537-5100
Mailing address
104 N MAIN ST, MARYSVILLE, OH 43040-1106
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/14/2019
Last updated
09/14/2019
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