Individual
DALLACE WOMBLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CDCA
Contact information
Practice address
4977 NORTHCUTT PL, DAYTON, OH 45414-3839
(800) 829-5461
Mailing address
816 WASHINGTON AVE, FAIRBORN, OH 45324-3840
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA185956
OH
Other
Enumeration date
12/11/2023
Last updated
12/11/2023
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