Individual
CARRIE STUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCDCIII
Contact information
Practice address
107 S MAIN ST STE B, CLYDE, OH 43410-1667
(419) 688-7812
Mailing address
12123 TOWNSHIP ROAD 178, BELLEVUE, OH 44811-9555
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCDCIII.111018
OH
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/08/2020
Last updated
04/18/2024
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