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1447007554
SHANICE MARIE SOUTHERN
COLUMBUS, OH
NPI
1447007554
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OH CDCA-183601)
Enumeration Date
2024-05-06
Last Update Date
2024-05-06
Business Address
SHANICE MARIE SOUTHERN CDCA,CHW
1791 ALUM CREEK DR
COLUMBUS, OH 43207-1708
Phone number: 614-324-5466
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Mailing Address
SHANICE MARIE SOUTHERN CDCA,CHW
7842 WORTHINGTON TRACE LN
COLUMBUS, OH 43085-5510
Phone number: 614-893-6270
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