| NPI | 1245681758 |
|---|---|
| Other Name | JACK A STODDARD |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SD 99041042) |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2016-06-27 |