Tyleeta J Madison, CDCA
Counselor in Lorain, OH. Individual provider (NPI-1).
NPI number1164065256
StatusActive
Last updated in NPPESOct 22, 2019
Details
- NPI
- 1164065256
- Entity type
- Individual (NPI-1)
- Name
- Tyleeta J Madison
- Credential
- CDCA
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 22, 2019
- Last updated
- Oct 22, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | CDCA.171102 | OH | Yes |
Practice location
2115 W Park DrLorain, OH 44053-1138
Phone 440-989-4900 · Fax 440-282-4779
Mailing address
2115 W Park DrLorain, OH 44053-1138
Phone 440-989-4900 · Fax 440-282-4779
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