Individual
GRANT CHARLES KIRKWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CDCA
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
165555
OH
106S00000X
Behavior Technician
—
OH
175T00000X
Peer Specialist
Primary
000120
OH
Other
Enumeration date
03/13/2017
Last updated
12/05/2024
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