Individual
MRS. CONNIE JO WORSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
515 GRAFTON AVE, DAYTON, OH 45406-5206
(937) 818-0042
Mailing address
45 VINCENT ST, DAYTON, OH 45405-4234
(937) 818-0042
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1130
—
OH
Enumeration date
01/07/2019
Last updated
01/07/2019
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