Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ADT984 | MD |
NPI | 1003212119 |
---|---|
Provider Name | Dr. John-Paul James |
First Address | Clinton, MD 20735-2555 |
Second Address | Clinton, MD 20735-1149 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2014 |
Last Update Date | 03/10/2019 |