Individual
MR. KEVIN LAVELLE MCDANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2680 W MARKET ST, FAIRLAWN, OH 44333-4215
(234) 867-5001
Mailing address
60 SOUTHWICK DR, BEDFORD, OH 44146-2624
(216) 526-6395
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2204069
OH
Other
Enumeration date
04/07/2022
Last updated
04/07/2022
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