Individual
DUSTIN GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDCA
Contact information
Practice address
8402 BLACKJACK ROAD EXT, MOUNT VERNON, OH 43050-9193
(740) 258-3587
Mailing address
8402 BLACKJACK ROAD EXT, MOUNT VERNON, OH 43050-9193
(740) 258-3587
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
090449
OH
Other
Enumeration date
11/07/2014
Last updated
11/07/2014
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