Individual
PAUL MATTHEW BRYDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LISAC-0914
Contact information
Practice address
1290 W ELKO ST, TUCSON, AZ 85704-2445
(520) 444-9733
Mailing address
1290 W ELKO ST, TUCSON, AZ 85704-2445
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC-0914
AZ
Other
Enumeration date
04/08/2009
Last updated
04/08/2009
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