JEROME LANE

SHELBY, OH
NPI1447837646
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OH  CDCA.176181)
Enumeration Date2021-03-25
Last Update Date2021-03-25
Business Address
JEROME LANE
2775 STATE ROUTE 39
SHELBY, OH 44875-9466
Phone number: 419-747-3322
Mailing Address
JEROME LANE
2775 STATE ROUTE 39
SHELBY, OH 44875-9466
Phone number: 419-747-3322
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