NPI | 1033284229 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: NM I0879) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OK 348) |
Enumeration Date | 2006-11-22 |
Last Update Date | 2013-03-21 |