Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | AC0166 | MD |
NPI | 1003082405 |
---|---|
Provider Name | Mr. William Thomas Menter |
First Address | Hagerstown, MD 21742-2741 |
Second Address | Hagerstown, MD 21742-2741 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2008 |
Last Update Date | 06/05/2008 |