Individual
MS. DIANE JUSTUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICDC-CS
Contact information
Practice address
16149 STATE ROUTE 104, CHILLICOTHE, OH 45601-9701
(740) 774-7050
Mailing address
ST. ROUTE 104, CHILLOCOTHE, OH 45601
(740) 774-7050
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
933627
OH
Other
Enumeration date
05/15/2015
Last updated
05/15/2015
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