NPI | 1003884644 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 4057) |
Additional Taxonomies | 101Y00000X Counselor (Licence: NC 4057) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ND LCAS-1194) | |
101YM0800X Counselor, Mental Health (Licence: NC 4057) | |
Enumeration Date | 2006-03-09 |
Last Update Date | 2024-09-20 |