Individual
LONNIE LANDRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1791 ALUM CREEK DR, COLUMBUS, OH 43207-1708
(614) 445-8131
(614) 324-5456
Mailing address
1791 ALUM CREEK DR, COLUMBUS, OH 43207-1708
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C1100526
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CDCA121502
CHEMICAL DEPENDENCY COUNSELING ASSISTANT
OH
Enumeration date
06/13/2016
Last updated
06/13/2016
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