Individual
MICHAEL CODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CADAC II, LAC
Contact information
Practice address
8000 MELTON RD, GARY, IN 46403-3114
(219) 938-4651
Mailing address
8000 MELTON RD, GARY, IN 46403-3114
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
86000050A
IN
Other
Enumeration date
08/07/2018
Last updated
08/07/2018
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