Individual
MR. ERIC OLIVER JEFFERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCDCII
Contact information
Practice address
4977 NORTHCUTT PL, DAYTON, OH 45414-3839
(800) 829-5461
Mailing address
1592 SHILOH SPRINGS RD APT D, DAYTON, OH 45426-2043
(937) 266-5642
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCDCII161991
OH
Other
Enumeration date
07/25/2019
Last updated
03/26/2024
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