| NPI | 1043725575 |
|---|---|
| Former Name | DONALD RAY DURANT |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 1325) |
| Enumeration Date | 2017-12-06 |
| Last Update Date | 2017-12-06 |