Individual
MR. DOUGLAS C DEROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICDC II
Contact information
Practice address
5209 DETROIT AVE, CLEVELAND, OH 44102-2224
(216) 325-9123
Mailing address
5209 DETROIT AVE, CLEVELAND, OH 44102-2224
(216) 325-9123
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
060103
OH
Other
Enumeration date
07/23/2015
Last updated
08/15/2024
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