# WALTER MABE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1629729553
- **Gender:** Man
- **Credential:** LADC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 1441 | CT | Yes |

## Other

- **Enumeration date:** 01/12/2022
- **Last updated:** 02/14/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 008023170 | — | CT |
| 05 | — | 008024427 | — | CT |
| 05 | — | 008039745 | — | CT |
| 05 | — | 008042339 | — | CT |
| 05 | — | 008107965 | — | CT |