DIANE FULTZ

MENTOR, OH
NPI1780197756
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OH  LCDCII.161560)
Additional Taxonomies171M00000X Case Manager/Care Coordinator
(Licence: OH  W.1300044)
Enumeration Date2017-11-13
Last Update Date2021-10-24
Business Address
DIANE FULTZ LCDCII, SWA, QMHS
7232 JUSTIN WAY
MENTOR, OH 44060-4881
Phone number: 440-578-8200
Mailing Address
DIANE FULTZ LCDCII, SWA, QMHS
7232 JUSTIN WAY
MENTOR, OH 44060-4881
Phone number: 440-578-8200