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Individual

DANIEL BOOKWALTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
411 COURT ST, PORTSMOUTH, OH 45662-3932
(740) 354-6685
Mailing address
923 FINDLAY ST, PORTSMOUTH, OH 45662-4148

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA.169415
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.172458
OH
101YM0800X
Mental Health Counselor
QMHS
171M00000X
Case Manager/Care Coordinator
CMS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0366291
OH
Enumeration date
05/20/2019
Last updated
03/16/2020
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