ALTON KEITH DAUGHERTY

MORAINE, OH
NPI1770083982
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OH  161525)
Enumeration Date2018-02-14
Last Update Date2018-02-14
Business Address
ALTON KEITH DAUGHERTY LCDC III
200 DARUMA PKWY
MORAINE, OH 45439-7909
Phone number: 937-963-5522
Mailing Address
ALTON KEITH DAUGHERTY LCDC III
1470 VERNON DR
DAYTON, OH 45406-4752
Phone number: 937-416-9030
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