NPI | 1144971821 |
---|---|
Other Name | CODA JATHO MCCAFFREY |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR T-22-1359) |
Enumeration Date | 2022-01-13 |
Last Update Date | 2022-01-13 |