Individual
CODY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CDCA
Contact information
Practice address
401 CENTER ST FRNT B, IRONTON, OH 45638-1519
(740) 479-5135
Mailing address
401 CENTER ST FRNT B, IRONTON, OH 45638-1519
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.184864
OH
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
08/02/2023
Last updated
10/20/2023
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