Individual
COREY JO GROOMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDCA
Contact information
Practice address
411 COURT ST, PORTSMOUTH, OH 45662-3932
(740) 354-6685
(740) 876-4005
Mailing address
2065 STONERIDGE DR, CIRCLEVILLE, OH 43113-8956
(740) 500-1391
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
175T00000X
Peer Specialist
Primary
APS.005750
OH
Other
Enumeration date
05/15/2024
Last updated
09/11/2025
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