| NPI | 1770047409 |
|---|---|
| Former Name | HOMER MCDUFFIE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LCDCll161678) |
| Enumeration Date | 2019-01-28 |
| Last Update Date | 2022-11-23 |