Individual
MICHAEL K DURHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICDC-CS
Contact information
Practice address
3113 STATE ROAD 580 LOT 355, SAFETY HARBOR, FL 34695-5929
(419) 709-6648
Mailing address
3113 STATE ROAD 580 LOT 355, SAFETY HARBOR, FL 34695-5929
(419) 709-6648
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LICDC.923266
OH
Other
Enumeration date
04/22/2024
Last updated
04/22/2024
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