Most Relevant Information
Provider Data
| NPI Number: | 1003351370 |
| Provider Name: | ELISE ANGELOS |
| Entity Type: | Individual |
| Taxonomy Code: | 101YP2500X |
| Specialty: | Counselor |
| License Number: | C.1500160 |
Most Important Dates
| Enumeration Date: | 12/22/2016 |
| Last Updated: | 08/01/2019 |
Provider Practice Location
800 GALLIA ST
SUITE 600
PORTSMOUTH
OH
456624035
Practice Location Phone/Fax
| Phone: | 7403534673 |
| Fax: | 7403535800 |
Provider Mailing Location
800 GALLIA ST STE 600
PORTSMOUTH
OH
456624097
Provider Mailing Phone/Fax
| Phone: | 7407279983 |
| Fax: |