Individual
MR. JASON JOHN IANNANTUONO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CDCA
Contact information
Practice address
800 PRO DR, CELINA, OH 45822-1360
(419) 586-4030
(419) 586-3268
Mailing address
800 PRO DR, CELINA, OH 45822-1360
(419) 586-4030
(419) 586-3268
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
070050
OH
Other
Enumeration date
07/09/2009
Last updated
07/09/2009
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