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Individual
MR. TEDDY IDEHEN
Active
Individual
MR. TEDDY IDEHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BSC, COUNSELOR
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
RI-10509270844
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RI-10509270844
ADDICTION COUNSELOR
CA
Enumeration date
04/25/2007
Last updated
07/08/2007
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