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Individual

JOHN DAVID HARRY

Active
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Individual

JOHN DAVID HARRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CADC-I, ICADC

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
AD10-034H
MS
171M00000X
Case Manager/Care Coordinator
AD10-034H
MS
251B00000X
Case Management Agency
AD10-034H
MS
251S00000X
Community/Behavioral Health Agency
AD10-034H
MS

Other

Enumeration date
09/15/2017
Last updated
09/15/2017
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