Individual provider · Type 1 NPI
Imhotep Mustaqeem
Addiction (Substance Use Disorder) Counselor · San Diego, CA
NPI number
1104220912
Active
Practice location
3336 Steel Street
San Diego, CA 92113
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | None listed |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1104220912
Imhotep Mustaqeem's National Provider Identifier is 1104220912, issued on Oct 22, 2014. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in San Diego, CA. The record was last updated on Oct 22, 2014.