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General NPI Number Information
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NPI Number | 1871891408
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Entity Type | Individual
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Provider Name | RICHARD KANIA MLADC
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Gender | Male
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Dates
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Enumeration Date | 03/07/2011
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Last Update Date | 04/15/2013
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Provider Practice Location Address
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Address Line | 6 FARMINGTON AVE
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City | HAVERHILL
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State | MA
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Zip | 01832-8607
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Country | US
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Telephone | 978-374-2876
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Fax |
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Provider Business Mailing Address
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Address Line | 6 FARMINGTON AVE
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City | HAVERHILL
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State | MA
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Zip | 01832-8607
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Country | US
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Telephone | 978-374-2876
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 0174
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License Number State | NH
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