Individual
NICHOLAS WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CDCA
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
0001998
OH
324500000X
Substance Abuse Rehabilitation Facility
—
OH
Other
Enumeration date
03/02/2017
Last updated
09/21/2020
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