NPI | 1003237785 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C009802) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 3528-A) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 3528) | |
1041C0700X Social Worker, Clinical (Licence: NC P008345) | |
Enumeration Date | 2013-12-23 |
Last Update Date | 2018-07-31 |