Provider Demographics
NPI:1871167866
Name:HOBBS, TERESA I (CDCA)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:I
Last Name:HOBBS
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7301 PAINESVILLE RAVENNA RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:44077-8928
Mailing Address - Country:US
Mailing Address - Phone:440-354-3726
Mailing Address - Fax:440-754-8029
Practice Address - Street 1:7301 PAINESVILLE RAVENNA RD
Practice Address - Street 2:
Practice Address - City:CONCORD TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:44077-8928
Practice Address - Country:US
Practice Address - Phone:440-354-3726
Practice Address - Fax:440-754-8029
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-14
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH172766101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)