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Individual
MIKE TIERNEY
Active
Individual
MIKE TIERNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC II
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
14-03-33
OR
Other
Enumeration date
04/11/2016
Last updated
11/02/2023
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