Individual provider · Type 1 NPI
Brad Deroma
Addiction (Substance Use Disorder) Counselor · Phoenix, AZ
NPI number
1902579998
Active
Practice location
15815 S Lakewood Pkwy W Apt 2016
Phoenix, AZ 85048-7291
Mailing address
15815 S Lakewood Pkwy W Apt 2119
Phoenix, AZ 85048-7294
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | None listed |
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | LIAC-155343 (AZ) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1902579998
Brad Deroma's National Provider Identifier is 1902579998, issued on Jul 27, 2021. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Phoenix, AZ. The record was last updated on Oct 23, 2024.