Individual
DEWAYNE LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICDC
Contact information
Practice address
680 PARK AVE W, MANSFIELD, OH 44906-3706
(567) 241-5481
Mailing address
680 PARK AVE W, MANSFIELD, OH 44906-3706
(567) 241-5481
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
141262
OH
101YM0800X
Mental Health Counselor
Primary
LICDC.161806
OH
Other
Enumeration date
01/16/2015
Last updated
12/03/2024
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