Individual
MR. DAMON LAMONT CRUELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CDCA
Contact information
Practice address
809 W VINE ST, LIMA, OH 45804-1054
(419) 222-4474
(419) 222-7044
Mailing address
809 W VINE ST, LIMA, OH 45804-1054
(419) 222-4474
(419) 222-7044
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1134502404
OH
251B00000X
Case Management Agency
1134502404
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134502404
—
OH
Enumeration date
07/06/2015
Last updated
07/07/2015
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