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Individual
DENNIS EAGLEEYE
Active
Individual
DENNIS EAGLEEYE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCDC III
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA.161969
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCDCIII.161692
OH
Other
Enumeration date
02/21/2017
Last updated
01/25/2022
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