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Individual

CARL N HENTHORN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCDCIII

Contact information

Practice address
36 N DETROIT ST, XENIA, OH 45385-2909
(937) 610-4673
Mailing address
100 CROWNE POINT PL, CINCINNATI, OH 45241-5427
(513) 942-4673

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCDCIII.162567
OH

Other

Enumeration date
10/10/2019
Last updated
06/20/2024
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