Individual
GREGORY M STOCKDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
62 E STEVENS ST, NEWARK, OH 43055-5969
(740) 366-7303
(740) 366-7305
Mailing address
62 E STEVENS ST, NEWARK, OH 43055-5969
(740) 366-7303
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
165824
OH
Other
Enumeration date
03/12/2018
Last updated
03/17/2018
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