MOLLIE COUNTRYMAN

FAIRBORN, OH
NPI1194348334
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Additional Taxonomies171M00000X Case Manager/Care Coordinator
Enumeration Date2020-05-22
Last Update Date2021-05-25
Business Address
MOLLIE COUNTRYMAN
323 N BROAD ST
FAIRBORN, OH 45324-4934
Phone number: 937-318-8103
Mailing Address
MOLLIE COUNTRYMAN
323 N BROAD ST
FAIRBORN, OH 45324-4934
Phone number: 937-318-8103