Individual
DENNIS EAGLEEYE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCDC III
Contact information
Practice address
14882 STATE ROUTE 13, THORNVILLE, OH 43076-8954
(740) 242-2300
(740) 276-2727
Mailing address
PO BOX 894, CAMBRIDGE, OH 43725-0894
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA.161969
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCDCIII.161692
OH
Other
Enumeration date
02/21/2017
Last updated
01/25/2022
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