Individual
JASON M DELUCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5760 PATRIOT BLVD, AUSTINTOWN, OH 44515-1170
(330) 953-0243
Mailing address
3239 MAIN ST, MINERAL RIDGE, OH 44440-9748
(330) 885-3009
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
171361
OH
Other
Enumeration date
11/12/2019
Last updated
11/12/2019
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