Provider Demographics
NPI:1356004899
Name:MARKOV, ADRIANA B
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:B
Last Name:MARKOV
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7893 DALEBROOK RD
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131-6607
Mailing Address - Country:US
Mailing Address - Phone:440-570-9846
Mailing Address - Fax:
Practice Address - Street 1:24500 CENTER RIDGE RD STE 395
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-5631
Practice Address - Country:US
Practice Address - Phone:440-570-9846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-21
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2103506-TRNE101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health