JAMES SAMPLE

DOVER, OH
NPI1396295168
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OH  CDCA.161142)
Enumeration Date2016-10-05
Last Update Date2016-10-05
Business Address
-- JAMES SAMPLE CDCA
897 E IRON AVE
DOVER, OH 44622-2030
Phone number: 330-343-5555
Mailing Address
-- JAMES SAMPLE CDCA
897 E IRON AVE
DOVER, OH 44622-2030
Phone number: 330-343-5555
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