Individual
JAMES KYLE BASHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CDCA
Contact information
Practice address
4130 LINDEN AVE STE 185, DAYTON, OH 45432-3040
(937) 380-2418
Mailing address
3804 FULTON AVE, MORAINE, OH 45439-2002
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
189825
OH
Other
Enumeration date
09/10/2024
Last updated
09/10/2024
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