Healthcare Provider Details

I. General information

NPI: 1427960293
Provider Name (Legal Business Name): MAKIENAOSHI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 W 1ST ST STE 209
DAYTON OH
45402-3033
US

IV. Provider business mailing address

301 W 1ST ST STE 209
DAYTON OH
45402-3033
US

V. Phone/Fax

Practice location:
  • Phone: 937-732-6642
  • Fax:
Mailing address:
  • Phone: 937-732-6642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MITZI HUTCHINS
Title or Position: MANAGING MEMBER
Credential: LPCC-S
Phone: 937-732-6642