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Individual

AUSTIN PEMBERTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
401 CENTER ST FRNT B, IRONTON, OH 45638-1519
(740) 479-5135
Mailing address
401 CENTER ST FRNT B, IRONTON, OH 45638-1519

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.183947
OH
171M00000X
Case Manager/Care Coordinator
OH

Other

Enumeration date
03/31/2023
Last updated
03/31/2023
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