Alicia Boreman-Menke, LPC/CR
Counselor in Sylvania, OH. Individual provider (NPI-1).
NPI number1104205194
StatusActive
Last updated in NPPESMay 22, 2015
Details
- NPI
- 1104205194
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Alicia Boreman-Menke
- Credential
- LPC/CR
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 22, 2015
- Last updated
- May 22, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | C.1400233-CR | OH | Yes |
| 101YM0800X | Counselor, Mental Health | C.1400233-CR | OH |
Practice location
5647 Mayberry SquareSylvania, OH 43560-9456
Phone 419-819-8428
Mailing address
2555 Berdan AveToledo, OH 43613-4805
Phone 419-819-8428
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