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General NPI Number Information
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NPI Number | 1538771282
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Entity Type | Individual
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Provider Name | FAITH MARIE PALMER C.D.C.A.
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Gender | Female
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Dates
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Enumeration Date | 08/22/2020
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2703 MAHONING AVE STE 105
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City | YOUNGSTOWN
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State | OH
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Zip | 44509-2337
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Country | US
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Telephone | 330-781-5107
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Fax | 234-312-9579
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Provider Business Mailing Address
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Address Line | 2861 E MARKET ST
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City | WARREN
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State | OH
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Zip | 44483-6263
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Country | US
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Telephone | 330-980-2353
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Fax | 234-312-9579
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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 |
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License Number State |
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