Individual
BRIAN MAURICE HAIRSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1440 SHERIDAN ST APT C8, CAMDEN, NJ 08104-1737
(856) 655-9354
Mailing address
1440 SHERIDAN ST APT C8, CAMDEN, NJ 08104-1737
(856) 655-9354
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
H01970967404922
NJ
Other
Enumeration date
04/30/2015
Last updated
04/30/2015
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