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1902200660
JEREMY JOHNSON
BOWLING GREEN, OH
NPI
1902200660
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OH 120949)
Enumeration Date
2014-10-09
Last Update Date
2014-10-09
Business Address
-- JEREMY JOHNSON
1022 N PROSPECT ST
BOWLING GREEN, OH 43402-1335
Phone number: 419-352-5387
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Mailing Address
-- JEREMY JOHNSON
PO BOX 29
BOWLING GREEN, OH 43402-0029
Phone number: 419-352-5387
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