Individual
JEREMY JAMES DILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14574 ST RT 23, WAVERLY, OH 45690
(740) 912-9126
Mailing address
418 POND RUN RD UNIT C, STOUT, OH 45684-9104
(740) 357-8810
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
10/28/2021
Last updated
10/28/2021
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