MR. Charles Earl Etheridge JR., CDCA

NPI #1245759794 in Elyria, Ohio

Provider Information

NPI Number
1245759794
Entity Type
Individual
Name
MR. Charles Earl Etheridge JR., CDCA
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Counselor - Addiction (Substance Use Disorder)
Credential
CDCA
Enumeration Date
Sep 15, 2017
Last Updated
Sep 15, 2017

Practice Location

Address
1131 E BROAD ST
City
Elyria
State
Ohio
ZIP Code
44035-6305
Phone
(440) 365-1900

Specialties & Taxonomy Codes

Specialty
Counselor - Addiction (Substance Use Disorder)Addiction (Substance Use Disorder)

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