Healthcare Provider Details

I. General information

NPI: 1336054899
Provider Name (Legal Business Name): LETTICIA BOEHM CDCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28407 STATE ROUTE 7
MARIETTA OH
45750-5152
US

IV. Provider business mailing address

885 E BUCHTEL AVE
AKRON OH
44305-2338
US

V. Phone/Fax

Practice location:
  • Phone: 740-371-5476
  • Fax:
Mailing address:
  • Phone: 330-535-8116
  • Fax: 330-996-2233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberPRS.006624
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCA.195082
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: