Individual
JAMES HENCEROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2951 MAPLE AVE, ZANESVILLE, OH 43701-1406
(740) 454-5927
Mailing address
2951 MAPLE AVE, ZANESVILLE, OH 43701-1406
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
981165
OH
1041C0700X
Clinical Social Worker
Primary
I0010090 SUPV
OH
Other
Enumeration date
08/08/2016
Last updated
08/08/2016
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