Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 23201 | NY |
NPI | 1003226283 |
---|---|
Provider Name | Rebekah Mosher |
First Address | Buffalo, NY 14215-2814 |
Second Address | Buffalo, NY 14215-2814 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2014 |
Last Update Date | 28/04/2014 |