| NPI | 1407253123 |
|---|---|
| Professional Name | WILLIE SHINE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC CSAC-20389) |
| Enumeration Date | 2014-11-24 |
| Last Update Date | 2014-11-24 |