Individual provider · Type 1 NPI

Derrell Anthony Fuqua Sr., CDCA

Addiction (Substance Use Disorder) Counselor · Dayton, OH

NPI number 1780158444 Active

Practice location

2529 Bridgeport Dr
Dayton, OH 45406-1433

Call (937) 278-0869 Map

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X169214 (OH)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1780158444

Derrell Anthony Fuqua Sr., CDCA's National Provider Identifier is 1780158444, issued on Jan 16, 2019. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Dayton, OH. The record was last updated on Jan 16, 2019.