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Individual

CHESTER R RALEIGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LICDC

Contact information

Practice address
3183 BEAVER VU DR STE C, BEAVERCREEK, OH 45434-6385
(937) 431-8014
(937) 431-8042
Mailing address
3183 BEAVER VU DR STE C, BEAVERCREEK, OH 45434-6385
(937) 431-8014
(937) 431-8042

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C.2103290
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
LICDC.161836
OH
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
10/25/2017
Last updated
07/29/2024
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