| 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 |