NPI | 1477087633 |
---|---|
Other Name | MARCELLUS BROOMES |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37LC00206800) |
Additional Taxonomies | 101Y00000X Counselor (Licence: NJ 37AC00232200) |
Enumeration Date | 2017-04-14 |
Last Update Date | 2017-04-14 |