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Addiction Substance Use Disorder

Clearwater, Florida

Provider NPI: 1326040726

Provider Information:
Gender: M
Sole Proprietor

Practice Location:
Tel: 727-446-8142  Fax: 727-466-0818

Business Mailing Address:
Tel: 727-446-8142  Fax: 727-466-0818

Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
N101YA0400XBehavioral Health & Social Service Providers
Addiction (Substance Use Disorder)
Y101YM0800XBehavioral Health & Social Service Providers
FLMH 4553


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