Johnson, Eslie Thomas

Johnson, Eslie Thomas is an individual health care provider with primary practice located at 3445 S Main St , Coventry Township OH 44319-3028. He recently has only one registered license in Other Service Providers / Peer Specialist, which is considered as his primary health care specialty. Johnson, Eslie Thomas can be contacted via phone (330) 644-4095.

Contact Information

Primary practice address
3445 S Main St Coventry Township OH 44319-3028
Phone: (330) 644-4095
Fax: (330) 644-2031
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Peer Specialist 175T00000X APS.000798 Ohio

Profile Details

NPI number 1639742273
LBN Legal business name Johnson, Eslie Thomas
Credentials PRS, CDCA
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2021
Last updated Jun 21st, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639742273 NPPES
Ohio MEDICAID 0452494

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