Doctor Name: | ADRIAN VERWAYNE |
NPI Number: | 1073906962 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 3562 Habersham At Northlake Building J Tucker, GA - 30084 |
Business Phone Number: | 6782617546 |
Business Fax Number: | |
Mailing Address: | 3562 Habersham At Northlake, Building J TUCKER |
State: | GA |
Postal Code: | 30084 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/17/2015 |
NPI Last Update Date: | 03/17/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |