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1487144952
KENNETH CORNELL JOHNSON
MANSFIELD, OH
NPI
1487144952
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OH 040353)
Enumeration Date
2018-05-10
Last Update Date
2018-05-10
Business Address
Mr. KENNETH CORNELL JOHNSON cdca
91 PARK AVE W
MANSFIELD, OH 44902-1630
Phone number: 567-307-7269
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Mailing Address
Mr. KENNETH CORNELL JOHNSON cdca
232 WIMBLEDON DR
MANSFIELD, OH 44906-2451
Phone number: 419-571-2188
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