Individual
BRIAN WOODSIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CIP, ICRC-ADC, CAC,
Contact information
Practice address
915 SWEETGRASS ST, LOXAHATCHEE, FL 33470-6127
(561) 376-6685
Mailing address
915 SWEETGRASS ST, LOXAHATCHEE, FL 33470-6127
(561) 376-6685
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
806449
FL
101YA0400X
Addiction (Substance Use Disorder) Counselor
CAC100072
FL
101YA0400X
Addiction (Substance Use Disorder) Counselor
CET100015
FL
101YA0400X
Addiction (Substance Use Disorder) Counselor
CRSS100026
FL
101YA0400X
Addiction (Substance Use Disorder) Counselor
I0181
PA
Other
Enumeration date
03/18/2020
Last updated
03/18/2020
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