Provider Demographics
NPI:1992501878
Name:DURR, ISABELLA RENAE (CDCA)
Entity type:Individual
Prefix:
First Name:ISABELLA
Middle Name:RENAE
Last Name:DURR
Suffix:
Gender:
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-2432
Mailing Address - Country:US
Mailing Address - Phone:740-201-2778
Mailing Address - Fax:
Practice Address - Street 1:625 GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-2432
Practice Address - Country:US
Practice Address - Phone:740-201-2778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH191571101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)