Individual
MR. GARY D. STANFORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.I.S.W.
Contact information
Practice address
8401 CLAUDE THOMAS RD, SUITE 21F, FRANKLIN, OH 45005-1497
(513) 535-7668
Mailing address
9733 DEBOLD KOEBEL RD, PLEASANT PLAIN, OH 45162-9353
(513) 535-7668
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
991476
OH
101YM0800X
Mental Health Counselor
Primary
I-0007783
OH
Other
Enumeration date
10/05/2006
Last updated
02/05/2009
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