Individual
HENRY FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1336 E MAIN ST, COLUMBUS, OH 43205-2081
(646) 327-1000
Mailing address
1336 E MAIN ST, COLUMBUS, OH 43205-2081
(646) 327-1000
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
OH
Other
Enumeration date
03/15/2016
Last updated
03/15/2016
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