Individual
CARLOS FUENTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
20 CHURCH ST, WHITE PLAINS, NY 10601-1901
(914) 421-0400
Mailing address
20 CHURCH ST, WHITE PLAINS, NY 10601-1901
(914) 421-0400
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
02249145
NY
Other
Enumeration date
07/14/2010
Last updated
07/14/2010
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