Gregory John Wightman, L.P.C.C. SUPV.

NPI #1073672275 in Dayton, Ohio

Provider Information

NPI Number: 1073672275
Entity Type: Individual
Name: Gregory John Wightman, L.P.C.C. SUPV.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor
Credential: L.P.C.C. SUPV.
Enumeration Date: Dec 6, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 2611 WAYNE AVE
Address 2: BUILDING #66
City: Dayton
State: Ohio
ZIP Code: 45420-1833
Phone: (937) 258-0440

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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