| Doctor Name: | MR. GEORGE M CODY |
| NPI Number: | 1083729602 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LGSW |
| License Number: | 19604 |
| Business Practice Address: | 120 Banjo Ln Centreville, MD - 216171002 |
| Business Phone Number: | 4107582211 |
| Business Fax Number: | |
| Mailing Address: | 120 Banjo Ln, CENTREVILLE |
| State: | MD |
| Postal Code: | 216171002 |
| Phone Number: | 4107582211 |
| Fax Number: | |
| NPI Enumeration Date: | 08/21/2006 |
| NPI Last Update Date: | 08/26/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 19604 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |