Tyleeta J Madison, CDCA

NPI #1164065256 in Lorain, Ohio

Provider Information

NPI Number: 1164065256
Entity Type: Individual
Name: Tyleeta J Madison, CDCA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor
Credential: CDCA
Enumeration Date: Oct 22, 2019
Last Updated: Oct 22, 2019

Practice Location

Address: 2115 W PARK DR
City: Lorain
State: Ohio
ZIP Code: 44053-1138
Phone: (440) 989-4900

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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