Individual
MR. NATHANIEL EDISON PONDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC, CTP-C
Contact information
Practice address
50430 SCHOOL HOUSE RD, CANTON, MI 48187-5910
(734) 495-1722
Mailing address
50430 SCHOOL HOUSE RD, CANTON, MI 48187-5910
(734) 495-1722
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
MI
Other
Enumeration date
09/09/2020
Last updated
09/10/2020
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