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General NPI Number Information
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NPI Number | 1245822071
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Entity Type | Individual
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Provider Name | HAILEE MARIE GEISENHOF LPC
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Gender | Female
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Dates
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Enumeration Date | 02/03/2021
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 4579 EVERHARD RD NW
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City | CANTON
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State | OH
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Zip | 44718-2425
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Country | US
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Telephone | 440-260-6466
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Fax |
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Provider Business Mailing Address
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Address Line | 2260 MURPHY LN E
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City | TROY
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State | OH
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Zip | 45373-2300
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Country | US
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Telephone | 630-212-4888
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | C.2406482
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License Number State | OH
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