Individual
COURTNEY PACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2016 LUNBECK RD, CHILLICOTHE, OH 45601-8903
(740) 947-6727
Mailing address
12370 STATE ROUTE 124, PIKETON, OH 45661-9143
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1275589178
—
OH
Enumeration date
02/08/2018
Last updated
02/08/2018
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