Individual
HARRISON DEWALT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
2775 STATE ROUTE 39, SHELBY, OH 44875-9466
(419) 747-3322
Mailing address
1730 BLUE LOCUST DR, MANSFIELD, OH 44905-2302
(419) 545-1164
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA.190266
OH
104100000X
Social Worker
Primary
S.2511830
OH
Other
Enumeration date
10/22/2024
Last updated
02/04/2025
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