Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 85373 | OH |
NPI | 1003085424 |
---|---|
Provider Name | Joseph N Lockett |
First Address | Canton, OH 44714-2605 |
Second Address | Canton, OH 44714-2605 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/02/2008 |
Last Update Date | 29/02/2008 |