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General NPI Number Information
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NPI Number | 1508360660
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Entity Type | Individual
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Provider Name | MINTA LANNING
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Gender | Female
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Dates
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Enumeration Date | 03/22/2018
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 31500 CHIEFTAIN DR STE ABC
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City | LOGAN
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State | OH
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Zip | 43138-8421
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Country | US
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Telephone | 740-270-3286
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Fax | 740-216-4597
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Provider Business Mailing Address
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Address Line | PO BOX 900926
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City | SANDY
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State | UT
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Zip | 84090-0926
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Country | US
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Telephone |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LICDC.162846
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | C.2507144
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License Number State | OH
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