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1194310318
JOHNNY SHAW
COLUMBUS, OH
NPI
1194310318
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MS CDCA.175616)
Enumeration Date
2021-03-09
Last Update Date
2021-03-09
Business Address
Mr. JOHNNY SHAW
1547 W BROAD ST
COLUMBUS, OH 43222-1043
Phone number: 614-352-2620
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Mailing Address
Mr. JOHNNY SHAW
1547 W BROAD ST
COLUMBUS, OH 43222-1043
Phone number: 614-352-2620
Copy
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