Tabitha M Braxton, CDCA
Counselor, Addiction (Substance Use Disorder) in Mount Vernon, OH. Individual provider (NPI-1).
NPI number1982170999
StatusActive
Last updated in NPPESFeb 27, 2019
Details
- NPI
- 1982170999
- Entity type
- Individual (NPI-1)
- Name
- Tabitha M Braxton
- Credential
- CDCA
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 17, 2018
- Last updated
- Feb 27, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | CDCA.169786 | OH | Yes |
| 171M00000X | Case Manager/Care Coordinator | – | – |
Practice location
213 E Chestnut StMount Vernon, OH 43050-3404
Phone 740-326-9255
Mailing address
213 E Chestnut StMount Vernon, OH 43050-3404
Phone 740-326-9255
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