Individual
JASON WIREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CAC I
Contact information
Practice address
974 WINSLOW TER, SUGAR HILL, GA 30518-6320
(404) 234-9099
Mailing address
974 WINSLOW TER, SUGAR HILL, GA 30518-6320
(404) 234-9099
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
02/04/2009
Last updated
02/04/2009
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