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Individual

MR. ROBERT TYSON WADE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MS.

Contact information

Practice address
1 FREEDOM WAY # 26, AUGUSTA, GA 30904-6258
(706) 733-0188
(706) 731-7190
Mailing address
1 FREEDOM WAY # 26, AUGUSTA, GA 30904-6258
(706) 733-0188
(706) 731-7190

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
09/11/2007
Last updated
09/11/2007
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