| NPI | 1922572221 |
|---|---|
| Other Name | ERIC DOUGLASS |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.150683) |
| Enumeration Date | 2019-01-20 |
| Last Update Date | 2021-09-30 |