Healthcare Provider Details

I. General information

NPI: 1508371717
Provider Name (Legal Business Name): ADAM HUFFMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2017
Last Update Date: 12/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 HIGHLAND AVE
CAMBRIDGE OH
43725-2529
US

IV. Provider business mailing address

317 HIGHLAND AVE
CAMBRIDGE OH
43725-2529
US

V. Phone/Fax

Practice location:
  • Phone: 740-435-9766
  • Fax: 740-432-4966
Mailing address:
  • Phone: 740-435-9766
  • Fax: 740-432-4966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.1200343
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: