Healthcare Provider Details

I. General information

NPI: 1326971334
Provider Name (Legal Business Name): TRAVIS HOYLMAN CDCA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 MARION PIKE
COAL GROVE OH
45638-2960
US

IV. Provider business mailing address

425 MARION PIKE
COAL GROVE OH
45638-2960
US

V. Phone/Fax

Practice location:
  • Phone: 740-377-1998
  • Fax:
Mailing address:
  • Phone: 740-377-1998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCA.192754
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: