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Search › Ohio › 101YA0400X

Justin Goubeaux, CDCA

NPI 1275189177 · on the registry since 2019 · sole proprietor

Practice

Address
714 E Main St
Trotwood, OH 45426
Phone
(937) 270-3329
Organisation at this address
Clean Slate Sober Living
Clean Slate Sober Living
Clean Slate Sober Living
Clean Slate Sober Living, Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
13

Registry record

Primary taxonomy
101YA0400X
101YA0400X
Also registered as
101YM0800X
171M00000X
Licence states on file
OH
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2019-08-15

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Ohio