| NPI | 1023563475 |
|---|---|
| Former Name | JENNIFER ANNE EPSTEIN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP00006351) |
| Enumeration Date | 2016-08-15 |
| Last Update Date | 2019-03-05 |