Individual
CHARLES BRANCH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDCA
Contact information
Practice address
551 1/2 E MAIN ST, LANCASTER, OH 43130-3809
(614) 404-6008
Mailing address
PO BOX 243, SUGAR GROVE, OH 43155-0243
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.178309
OH
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
01/05/2021
Last updated
03/02/2022
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