Doctor Name: | KENNETH TOTH |
NPI Number: | 1184016271 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CDCA |
License Number: | 110036 |
Business Practice Address: | 30800 Chagrin Blvd Pepper Pike, OH - 441245925 |
Business Phone Number: | 2165910324 |
Business Fax Number: | |
Mailing Address: | 30800 Chagrin Blvd, PEPPER PIKE |
State: | OH |
Postal Code: | 441245925 |
Phone Number: | 2165910324 |
Fax Number: | |
NPI Enumeration Date: | 02/26/2015 |
NPI Last Update Date: | 02/26/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 110036 |
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: |