NPI | 1083729602 |
---|---|
Former Name | GEORGE M CODY |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD 19604) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 12884) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD 19604) | |
101YM0800X Counselor, Mental Health (Licence: CT 12884) | |
Enumeration Date | 2006-08-21 |
Last Update Date | 2025-01-10 |