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General NPI Number Information
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NPI Number | 1417551755
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Entity Type | Organization
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Legal Business Name | REDEFINING COUNSELING, LLC
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Dates
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Enumeration Date | 11/27/2020
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Last Update Date | 11/27/2020
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Provider Practice Location Address
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Address Line | 8400 E MARKET ST
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City | WARREN
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State | OH
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Zip | 44484-2362
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Country | US
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Telephone | 937-889-1898
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Fax |
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Provider Business Mailing Address
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Address Line | 115 MISTLETOE RD
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City | NILES
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State | OH
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Zip | 44446-2107
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Country | US
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Telephone | 858-444-7779
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Fax |
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Authorized Official
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Title or Position | CEO/ OWNER
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Name | TABBETHIA A SQUEZELLO
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Credential |
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Telephone | 937-889-1898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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