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1376625384
CHARLES R JOHNSON
DAYTON, OH
NPI
1376625384
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OH LCDC II 991546)
Enumeration Date
2006-10-19
Last Update Date
2007-07-08
Business Address
-- CHARLES R JOHNSON LCDC II
4100 W 3RD ST VETERANS MEDICAL CENTER
DAYTON, OH 45428-9000
Phone number: 937-268-6511
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Mailing Address
-- CHARLES R JOHNSON LCDC II
1446 CORNELL DR
DAYTON, OH 45406-4726
Phone number: 937-277-2769
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