Individual
TITUS V BROOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSAC-R
Contact information
Practice address
2211 W MOREHEAD ST, CHARLOTTE, NC 28208-5143
(980) 422-9653
Mailing address
4607 CRICKLEWOOD LN, CHARLOTTE, NC 28212-8525
(980) 422-9653
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/15/2019
Last updated
01/15/2019
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