Healthcare Provider Details

I. General information

NPI: 1104003375
Provider Name (Legal Business Name): ROZELLE NATALIE ALLEN M.ED., LPCC, CTS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROZELLE NATALIE ALLEN M.ED.,PCC

II. Dates (important events)

Enumeration Date: 01/29/2008
Last Update Date: 09/09/2022
Certification Date: 09/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3445 S MAIN ST
COVENTRY TOWNSHIP OH
44319-3028
US

IV. Provider business mailing address

3445 S MAIN ST
COVENTRY TOWNSHIP OH
44319-3028
US

V. Phone/Fax

Practice location:
  • Phone: 330-644-4095
  • Fax:
Mailing address:
  • Phone: 330-644-4095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.0600225
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC.0600225
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: