Individual
GARY ALAN RICHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
2957 MAIN ST. RT. 302, BETHLEHEM, NH 03574
(606) 707-5076
(603) 869-2355
Mailing address
2957 MAIN ST. RT. 302, BETHLEHEM, NH 03574
(606) 707-5076
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1130
NH
Other
Enumeration date
11/05/2020
Last updated
11/05/2020
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