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Individual

JAMES DAVID HARTIGAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.ED.

Contact information

Practice address
SIDNEY AND LAMONT, MOUNTAIN HOME, JOHNSON CITY, TN 37684
(423) 926-1171
Mailing address
1825 W LAKEVIEW DR, R-133, JOHNSON CITY, TN 37601-2193
(423) 926-1171

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
C551
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C551
COUNSELOR
IN
Enumeration date
08/02/2006
Last updated
07/08/2007
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