Full Name | |
---|---|
Speciality | Counselor |
Location | 37303 Harvest Ave, Avon, Ohio |
Authorized Official Name and Position | Angela Dover (OWNER) |
Authorized Official Contact | 5132535137 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
37303 Harvest Ave Avon OH 44011-2803 Ph: (440) 847-8505 | 37303 Harvest Ave Avon OH 44011 Ph: (440) 847-8505 |
NPI Number | 1730536723 |
---|---|
Provider Enumeration Date | 05/19/2016 |
Last Update Date | 11/15/2024 |
Certification Date | 11/15/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1730536723 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | E.0008336 (Ohio) | Primary |
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