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1013572676
LANEISHA TIANT GARDNER
MORAINE, OH
NPI
1013572676
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OH CDCA.170323)
Enumeration Date
2019-05-08
Last Update Date
2019-05-08
Business Address
LANEISHA TIANT GARDNER CDCA
200 DARUMA PKWY
MORAINE, OH 45439-7909
Phone number: 937-262-3500
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Mailing Address
LANEISHA TIANT GARDNER CDCA
73 CROWN AVE
DAYTON, OH 45417-9017
Phone number: 937-630-2368
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