Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | C. 0007713 | OH |
NPI | 1003205014 |
---|---|
Provider Name | Joni Brown |
First Address | Twinsburg, OH 44087-2351 |
Second Address | Twinsburg, OH 44087-2351 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2015 |
Last Update Date | 14/01/2015 |