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1821500539
WILLIAM BRAXTON PROWELL
MASSILLON, OH
NPI
1821500539
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OH CDCA.163719)
Enumeration Date
2017-11-03
Last Update Date
2017-11-03
Business Address
WILLIAM BRAXTON PROWELL CDCA
1680 NAVE RD SE
MASSILLON, OH 44646-9604
Phone number: 330-830-8740
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Mailing Address
WILLIAM BRAXTON PROWELL CDCA
625 CLEVELAND AVE NW
CANTON, OH 44702-1805
Phone number: 330-455-0374
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