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Individual
TIMOTHY MICHAEL BAMBARA
Active
Individual
TIMOTHY MICHAEL BAMBARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RESIDENT COUNSELING
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0719000028
VA
Other
Enumeration date
08/23/2023
Last updated
08/23/2023
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