Individual
ERIC DOUGLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4977 NORTHCUTT PL, DAYTON, OH 45414-3839
(937) 387-6395
Mailing address
4009 FOXBORO DR, DAYTON, OH 45416-1624
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.150683
OH
Other
Enumeration date
01/20/2019
Last updated
09/30/2021
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