Individual
CODY WATERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ADT
Contact information
Practice address
205 BROADWAY ST STE 110, FREDERICK, MD 21701-6760
(301) 637-0222
Mailing address
205 BROADWAY ST STE 110, FREDERICK, MD 21701-6760
(301) 637-0222
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ADT3307
MD
Other
Enumeration date
08/14/2023
Last updated
08/14/2023
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