Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 174906 | OH |
NPI | 1003408147 |
---|---|
Provider Name | Daniel Reece |
First Address | Dayton, OH 45417-3445 |
Second Address | Dayton, OH 45417-3445 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2021 |
Last Update Date | 10/02/2021 |