Individual
MR. DEXTER ANTONIO WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, CAC-AD
Contact information
Practice address
3455 WILKENS AVE LOWR LEVEL20, BALTIMORE, MD 21229-5213
(410) 646-6970
Mailing address
3455 WILKENS AVE LOWR LEVEL20, BALTIMORE, MD 21229-5213
(410) 646-6970
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
AC1502
MD
Other
Enumeration date
01/07/2022
Last updated
01/07/2022
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