person
Eric Clinton Wallace
Addiction (Substance Use Disorder) Counselor in West Union, Ohio
NPI 1366955585

Eric Clinton Wallace is an Addiction (Substance Use Disorder) Counselor based in Cincinnati, OH and is specialized in Addiction (Substance Use Disorder). Eric Clinton Wallace practices in West Union, OH. The NPI Number for Eric Clinton Wallace is 1366955585 and holds a License No. CDCA.164839 (Ohio).

The current practice location address for Eric Clinton Wallace is 247 Cic Blvd, West Union, OH and can be reached out via phone at 513-941-4999 and via fax at 513-694-0168.

Location: 247 Cic Blvd, West Union, OH, 45247-7958
person
Provider Profile Details
NPI Number
1366955585
Provider Name
Eric Clinton Wallace
Credential
Provider Entity Type
Individual
Gender
Male
Address
247 Cic Blvd, West Union, OH, 45247-7958
Phone Number
513-941-4999
Fax Number
513-694-0168
Provider Enumeration Date
11/09/2017
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0273638 05 OH
institution
Provider Business Practice Location Address Details
Address
247 Cic Blvd
City
State
Zip
45693-7512
Phone Number
513-941-4999
Fax Number
513-694-0168
person
Provider Business Mailing Address Details
Address
247 Cic Blvd
City
State
Zip
45693-7512
Phone Number
513-941-4999
Fax Number
513-694-0168
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
QMHS (Ohio)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
CDCA.164839 (Ohio)
Definition
Definition to come...
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