Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | CDCA.120145 | OH |
NPI | 1003365933 |
---|---|
Provider Name | Hillary A Whiteman |
First Address | Canton, OH 44702-1805 |
Second Address | Canton, OH 44714-2605 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2016 |
Last Update Date | 04/10/2016 |