Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | C.1400561 | OH |
NPI | 1003200296 |
---|---|
Provider Name | Allyson Mccarley |
First Address | Lakewood, OH 44107-3825 |
Second Address | Cleveland, OH 44113-3086 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2015 |
Last Update Date | 09/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2844093 | (05) | OH |