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General NPI Number Information
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NPI Number | 1467981225
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Entity Type | Organization
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Legal Business Name | RESTORATION COUNSELING, LLC
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Dates
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Enumeration Date | 06/06/2017
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Last Update Date | 06/06/2017
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Provider Practice Location Address
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Address Line | 197 W MAIN ST STE D
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City | CORTLAND
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State | OH
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Zip | 44410-1460
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Country | US
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Telephone | 330-219-5345
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Fax |
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Provider Business Mailing Address
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Address Line | 1020 FAIRWAY CT NE
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City | WARREN
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State | OH
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Zip | 44483-5663
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Country | US
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Telephone | 330-219-5345
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DEIRDRE KATHERINE ADDUCI
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Credential | PHD
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Telephone | 330-219-5345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | E-0008081-SUPV
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License Number State | OH
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