| Organization Name: | JUDITH MARINICH, INC. |
| NPI Number: | 1003047291 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JUDITH T MARINICH (OWNER) |
| Mailing Address: | 38039 W Spaulding St Willoughby |
| State: | OH US |
| Postal Code: | 440946110 |
| Phone Number: | 4409181806 |
| Fax Number: | 4409181807 |
| NPI Enumeration Date: | 08/05/2009 |
| NPI Last Update Date: | 08/05/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 981392 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |