Individual
AUSTIN LEE JAMES FARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4945 STATE ROUTE 339, VINCENT, OH 45784-5106
(740) 993-0399
Mailing address
4945 STATE ROUTE 339, VINCENT, OH 45784-5106
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.184481
OH
Other
Enumeration date
06/14/2023
Last updated
06/14/2023
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