NPI | 1013430834 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH15250) |
Additional Taxonomies | 101Y00000X Counselor (Licence: MS 1854) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MS 102) | |
104100000X Social Worker (Licence: FL MH15250) | |
Enumeration Date | 2017-07-24 |
Last Update Date | 2019-04-16 |