Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | ||
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 161742 | OH |
NPI | 1003329079 |
---|---|
Provider Name | Ashley Nichole Focht |
First Address | Mentor, OH 44060-4881 |
Second Address | Mentor, OH 44060-4881 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2017 |
Last Update Date | 05/01/2022 |