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12 West Wenger Road, Suite S Englewood OH 45322 | |
| (210) 405-8981 | |
| (937) 962-6210 |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 12 West Wenger Road,, Englewood, Ohio |
| Authorized Official Name and Position | Jeralyn R Tharp (OWNER) |
| Authorized Official Contact | 8508892880 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2186 Jackson Keller Rd Suite 2223 San Antonio TX 78213 Ph: (210) 405-8981 | 12 West Wenger Road, Suite S Englewood OH 45322 Ph: (210) 405-8981 |
| NPI Number | 1073237343 |
|---|---|
| Provider Enumeration Date | 09/30/2022 |
| Last Update Date | 11/22/2024 |
| Certification Date | 09/30/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073237343 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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