Individual
DARNELL LARRY EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CDCA
Contact information
Practice address
245 BEALL AVE, WOOSTER, OH 44691-3674
(330) 262-6903
(330) 264-0646
Mailing address
104 SPINK ST, WOOSTER, OH 44691-3652
(330) 264-8498
(330) 264-3777
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
161386
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
161386
SUD COUNSELOR
OH
05
—
161386
—
OH
Enumeration date
06/29/2018
Last updated
06/29/2018
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