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Individual

GREGORY HEPBURN

Active
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Individual

GREGORY HEPBURN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MA

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
16911
NY
101YM0800X
Mental Health Counselor
Primary
001753-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12576044
CAQH
NY
Enumeration date
01/17/2008
Last updated
11/19/2013
About Stedi
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