Individual provider · Type 1 NPI

Mary Bruce, LCDCIII

Addiction (Substance Use Disorder) Counselor · Coal Grove, OH

NPI number 1104339134 Active

Practice location

425 Marion Pike
Coal Grove, OH 45638-2960

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400XLCDCII.161421 (OH)
Case Manager/Care Coordinator 171M00000XNone listed
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XLCDCIII.161773

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About NPI 1104339134

Mary Bruce, LCDCIII's National Provider Identifier is 1104339134, issued on Nov 13, 2017. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Coal Grove, OH. The record was last updated on Sep 6, 2023.