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Tammy J Bush, LCDC111

Counselor, Addiction (Substance Use Disorder) in Pomeroy, OH. Individual provider (NPI-1).

NPI number1861998445
StatusActive
Last updated in NPPESJun 16, 2018

Details

NPI
1861998445
Entity type
Individual (NPI-1)
Name
Tammy J Bush
Credential
LCDC111
Sex
Female
Sole proprietor
No
Enumeration date
Apr 3, 2018
Last updated
Jun 16, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YA0400X Counselor, Addiction (Substance Use Disorder)121119OHYes

Practice location

507 Mulberry Heights Rd
Pomeroy, OH 45769-9573

Phone 740-992-5277 · Fax 740-992-7264

Mailing address

224 Columbus Rd
Athens, OH 45701-1334

Phone 740-592-6724 · Fax 740-592-6728

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