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1689079113
WILLIE ALTON HENRY
BROCKTON, MA
NPI
1689079113
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2014-10-27
Last Update Date
2014-10-27
Business Address
Mr. WILLIE ALTON HENRY
180 CENTRE ST
BROCKTON, MA 02302-2733
Phone number: 617-479-0102
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Mailing Address
Mr. WILLIE ALTON HENRY
180 CENTRE ST
BROCKTON, MA 02302-2733
Phone number: 617-479-0102
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