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General NPI Number Information
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NPI Number | 1114553666
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Entity Type | Individual
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Provider Name | PAULA LYNN RETTIG LPC LCDCII
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Gender | Female
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Dates
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Enumeration Date | 03/17/2020
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Last Update Date | 03/17/2020
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Provider Practice Location Address
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Address Line | 22897 US-20 ALT
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City | ARCHBOLD
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State | OH
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Zip | 43502
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Country | US
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Telephone | 419-445-1980
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Fax |
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Provider Business Mailing Address
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Address Line | 12484 STATE ROUTE 110
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City | NAPOLEON
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State | OH
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Zip | 43545-9340
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Country | US
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Telephone | 419-310-7360
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 1500304
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License Number State | OH
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