Provider Demographics
NPI:1053828251
Name:DOSSER, DAVID (LCDC III)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:DOSSER
Suffix:
Gender:M
Credentials:LCDC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:COSHOCTON
Mailing Address - State:OH
Mailing Address - Zip Code:43812-1655
Mailing Address - Country:US
Mailing Address - Phone:740-622-0033
Mailing Address - Fax:740-622-0210
Practice Address - Street 1:610 WALNUT ST
Practice Address - Street 2:
Practice Address - City:COSHOCTON
Practice Address - State:OH
Practice Address - Zip Code:43812-1655
Practice Address - Country:US
Practice Address - Phone:740-622-0033
Practice Address - Fax:740-622-0210
Is Sole Proprietor?:No
Enumeration Date:2018-01-09
Last Update Date:2018-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH161311101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)