| Doctor Name: | MARK B APPLEGATE |
| NPI Number: | 1083075808 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CDCA |
| License Number: | 130287 |
| Business Practice Address: | 2115 West Park Drive Lorain, OH - 44053 |
| Business Phone Number: | 4409894987 |
| Business Fax Number: | 4402824779 |
| Mailing Address: | 2115 West Park Drive, LORAIN |
| State: | OH |
| Postal Code: | 44053 |
| Phone Number: | 4409894987 |
| Fax Number: | 4402824779 |
| NPI Enumeration Date: | 03/08/2016 |
| NPI Last Update Date: | 03/08/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 130287 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |