Individual
CHARLES MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDCA
Contact information
Practice address
2801 C CT, ASHTABULA, OH 44004-4577
(440) 998-0722
(440) 992-1699
Mailing address
2801 C CT, ASHTABULA, OH 44004-4577
(440) 998-0722
(440) 992-1699
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
130346
OH
Other
Enumeration date
04/13/2018
Last updated
04/13/2018
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