Individual
COREY DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
712 EAST 2ND ST, 6891, FRANKLIN, OH 45005
(937) 516-1957
Mailing address
PO BOX 6891, FRANKLIN, OH 45005-6891
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
252491
KY
Other
Enumeration date
12/25/2020
Last updated
12/25/2020
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