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Individual

TONY LEVON JERRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCDC

Contact information

Practice address
2368 CENTER STONE LN, RIVIERA BEACH, FL 33404-1828
(713) 859-7814
Mailing address
2368 CENTER STONE LN, RIVIERA BEACH, FL 33404-1828
(713) 859-7814

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
14828
TX

Other

Enumeration date
08/23/2023
Last updated
08/24/2023
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