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Individual

MR. DWAYNE M MURRAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CASAC

Contact information

Practice address
1276 FULTON AVE FL 7, BRONX, NY 10456-3402
(718) 901-8862
Mailing address
1276 FULTON AVE, 7TH FLOOR FULTON, BRONX, NY 10456-3402

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13105
NY
283Q00000X
Psychiatric Hospital
13105
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13105
CASAC
NY
Enumeration date
02/02/2009
Last updated
02/02/2009
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