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Individual
FRED TIMOTHY JONES
Active
Individual
FRED TIMOTHY JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDCA, CMS
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA.165754
OH
171M00000X
Case Manager/Care Coordinator
Primary
—
OH
Other
Enumeration date
08/28/2017
Last updated
12/27/2018
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