Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | E. 0808098 | OH |
Y | 101YP2500X | Professional Counselor | E. 0808098 | OH |
NPI | 1003276668 |
---|---|
Provider Name | Amy Zeglen |
First Address | Akron, OH 44305-2421 |
Second Address | Akron, OH 44320-2326 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/02/2016 |
Last Update Date | 25/02/2016 |