Individual
MR. TIMOTHY SCOTT NUGENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CAP
Contact information
Practice address
2180 MARAVILLA LN, FORT MYERS, FL 33901-7221
(239) 332-8009
Mailing address
2180 MARAVILLA LN, FORT MYERS, FL 33901-7221
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2164
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2164
CERTIFIED ADDICTION PROFESSIONAL
FL
Enumeration date
10/13/2011
Last updated
10/13/2011
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