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Individual
MR. LATIMER BRECK ALEXANDER V
Active
Individual
MR. LATIMER BRECK ALEXANDER V
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW-A, LCAS-A
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
21985
NC
1041C0700X
Clinical Social Worker
P015590
NC
1041C0700X
Clinical Social Worker
PO10755
NC
Other
Enumeration date
05/18/2016
Last updated
04/18/2023
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