Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | CAC5421 | ME |
NPI | 1003232836 |
---|---|
Provider Name | David R French |
First Address | Brunswick, ME 04011-2673 |
Second Address | Brunswick, ME 04011-2673 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2014 |
Last Update Date | 18/03/2014 |