Individual
IRVIN ALONZO MCDONALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
332 LINWOOD ST, DAYTON, OH 45405-4918
(937) 529-4996
(937) 529-0055
Mailing address
PO BOX 219, DAYTON, OH 45405-0219
(937) 305-5119
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
01/22/2020
Last updated
04/22/2020
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