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NPI Code Detail

MEDICARE: TIMOTHY WAYNE HUBBELL I CDCA

MEDICARE: TIMOTHY WAYNE HUBBELL I CDCA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor160762OH

General Provider Information

NPI Number : 1871044974
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY WAYNE HUBBELL I CDCA
Provider Business Mailing Address
First Line : 201 S COLUMBUS ST
Second Line :
City : LANCASTER
State : OH
Zip : 43130-4315
Country : US
Telephone Number : 740-687-4500
Fax Number : 740-687-4595
Provider Business Practice Location Address
First Line : 201 S COLUMBUS ST
Second Line :
City : LANCASTER
State : OH
Zip : 43130-4315
Country : US
Telephone Number : 740-687-4500
Fax Number : 740-687-4595
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2016
Last Update Date : 10/24/2016

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Directions to “ TIMOTHY WAYNE HUBBELL I CDCA” Practice Location

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