Doctor Name: | ANGELIA K DUSSIA |
NPI Number: | 1154490936 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, PCC, CDCA |
License Number: | C0500552 |
Business Practice Address: | 2675 Medway New Carlisle Rd Medway, OH - 453419744 |
Business Phone Number: | 9378491257 |
Business Fax Number: | 9378491336 |
Mailing Address: | 2675 Medway New Carlisle Rd, MEDWAY |
State: | OH |
Postal Code: | 453419744 |
Phone Number: | 9378491257 |
Fax Number: | 9378491336 |
NPI Enumeration Date: | 11/07/2006 |
NPI Last Update Date: | 01/24/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | C0500552 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |