NPI | 1053053934 |
---|---|
Other Name | EDDY DEHERRERA |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA C061261876) |
Enumeration Date | 2022-04-11 |
Last Update Date | 2022-04-11 |