NPI | 1023571072 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP61144138) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2019-04-08 |
Last Update Date | 2023-05-22 |