Doctor Name: | THERESA CORIELL |
NPI Number: | 1043570096 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPCC |
License Number: | E.0800357 |
Business Practice Address: | 230 S Court St 5 Medina, OH - 442562275 |
Business Phone Number: | 3307237977 |
Business Fax Number: | |
Mailing Address: | 230 S Court St, 5 MEDINA |
State: | OH |
Postal Code: | 442562275 |
Phone Number: | 3307237977 |
Fax Number: | |
NPI Enumeration Date: | 05/24/2012 |
NPI Last Update Date: | 05/24/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | E.0800357 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |