Healthcare Provider Details

I. General information

NPI: 1013568419
Provider Name (Legal Business Name): JOSLYNN ELIZABETH PRETTY MA, CDCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2019
Last Update Date: 08/26/2024
Certification Date: 08/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 BAVARIAN ST APT B
MIDDLETOWN OH
45044-5448
US

IV. Provider business mailing address

110 BAVARIAN ST APT B
MIDDLETOWN OH
45044-5448
US

V. Phone/Fax

Practice location:
  • Phone: 513-567-0900
  • Fax:
Mailing address:
  • Phone: 513-567-0900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCA.188501
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number09312832
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: