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Individual
WILLIE EDWARD
Active
Individual
WILLIE EDWARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0152
MS
Other
Enumeration date
03/17/2014
Last updated
03/17/2014
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