Individual
HARRY SHANE FALWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
104100000X
Social Worker
—
—
172A00000X
Driver
—
—
174400000X
Specialist
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
06/01/2020
Last updated
06/01/2020
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