Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 10205 | TX |
NPI | 1003124926 |
---|---|
Provider Name | Mr. Paul James Brazinskas |
First Address | Midland, TX 79701-4803 |
Second Address | Midland, TX 79701-4803 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2010 |
Last Update Date | 14/09/2010 |