Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) |
NPI | 1003326927 |
---|---|
Provider Name | Mrs. Tina Marie Rhodes |
First Address | Youngstown, OH 44507-1535 |
Second Address | Youngstown, OH 44502-1866 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2017 |
Last Update Date | 02/12/2019 |