Individual
MR. GEOFFREY S FANNIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1616 GRANT ST, PORTSMOUTH, OH 45662-3663
(740) 901-0416
Mailing address
1616 GRANT ST, PORTSMOUTH, OH 45662-3663
(937) 260-5652
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.1800093
OH
Other
Enumeration date
07/18/2022
Last updated
07/18/2022
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