Individual
CHARLES R JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCDC II
Contact information
Practice address
4100 W 3RD ST, VETERANS MEDICAL CENTER, DAYTON, OH 45428-9000
(937) 268-6511
Mailing address
1446 CORNELL DR, DAYTON, OH 45406-4726
(937) 277-2769
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCDC II 991546
OH
Other
Enumeration date
10/19/2006
Last updated
07/08/2007
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