Individual
MOSES DOUSE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CASAC 2-20038
Contact information
Practice address
882 BERGEN ST, BROOKLYN, NY 11238-1123
(718) 613-7510
(718) 613-7564
Mailing address
882 BERGEN ST, OTP-MMT, BROOKLYN, NY 11238
(718) 613-7510
(718) 613-7564
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
20038
NY
Other
Enumeration date
05/14/2021
Last updated
05/14/2021
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