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725 Boardman Canfield Rd Ste L1 Youngstown OH 44512-4370 | |
| (330) 330-8655 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor - Professional |
| Location | 725 Boardman Canfield Rd Ste L1, Youngstown, Ohio |
| Authorized Official Name and Position | Rhonda Hanni (OFFICE MANAGER) |
| Authorized Official Contact | 3303308655 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
725 Boardman Canfield Rd Ste L1 Youngstown OH 44512-4370 Ph: (330) 330-8655 | 725 Boardman Canfield Rd Ste L1 Youngstown OH 44512-4370 Ph: (330) 330-8655 |
| NPI Number | 1255979779 |
|---|---|
| Provider Enumeration Date | 12/16/2019 |
| Last Update Date | 12/17/2019 |
| Certification Date | 12/17/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255979779 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| 363A00000X | Physician Assistant | (* (Not Available)) | Secondary |
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