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Individual

ANTHONY WAYNE JUSTICE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CDCA-PRE

Contact information

Practice address
15221 STATE ROUTE 772, PIKETON, OH 45661-9062
(740) 493-4260
Mailing address
218 E NORTH ST, WAVERLY, OH 45690-1148
(740) 947-6727

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
164626
OH

Other

Enumeration date
10/19/2017
Last updated
10/19/2017
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