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Individual

NATHANIEL DANTE HASKINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DSP

Contact information

Practice address
1111 SEYMOUR DR, ASHTABULA, OH 44004-5511
(440) 645-0633
Mailing address
1640 W 5TH ST, ASHTABULA, OH 44004-2834
(440) 645-0366

Taxonomy

Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
000111
OH

Other

Enumeration date
08/18/2021
Last updated
08/18/2021
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