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Individual

JAMES EDWARD MONFORT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCDCIII

Contact information

Practice address
333 N MAIN ST, LIMA, OH 45801-4434
(419) 234-1174
Mailing address
1937 WENDELL AVE, LIMA, OH 45805-3162

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
021379
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NONE
NONE
Enumeration date
02/28/2018
Last updated
02/28/2018
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