Provider Demographics
NPI:1083247415
Name:OXNER, DAVID VIRGIL JR (CDCA)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:VIRGIL
Last Name:OXNER
Suffix:JR
Gender:M
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2822 UPTON AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-3959
Mailing Address - Country:US
Mailing Address - Phone:419-737-6021
Mailing Address - Fax:
Practice Address - Street 1:2822 UPTON AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-3959
Practice Address - Country:US
Practice Address - Phone:419-737-6021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-13
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH170574101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)