Provider Demographics
NPI:1326450552
Name:MARES, PATRICIA BROWN (PCC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:BROWN
Last Name:MARES
Suffix:
Gender:F
Credentials:PCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:628 COMMANCHE RD
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-1215
Mailing Address - Country:US
Mailing Address - Phone:740-703-5048
Mailing Address - Fax:740-721-4155
Practice Address - Street 1:628 COMMANCHE RD
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-1215
Practice Address - Country:US
Practice Address - Phone:740-703-5048
Practice Address - Fax:740-721-4155
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-22
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0900309101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional