NPI | 1013440379 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: CA A060761221) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
225C00000X Rehabilitation Counselor | |
Enumeration Date | 2017-04-04 |
Last Update Date | 2024-05-06 |