NPI | 1760104699 |
---|---|
Other Name | BRANDON HEREFORD RICHARD-RICKE |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Enumeration Date | 2022-09-16 |
Last Update Date | 2025-04-22 |