Individual
MR. BRIAN DALE FUGATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDCA
Contact information
Practice address
7811 FERNBANK CT, HUBER HEIGHTS, OH 45424-1905
(937) 580-4251
Mailing address
7811 FERNBANK CT, HUBER HEIGHTS, OH 45424-1905
(937) 580-4251
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
168526
OH
Other
Enumeration date
06/03/2019
Last updated
06/03/2019
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