NPI | 1033410881 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NV 5809-C) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NV 00160-LC) |
Enumeration Date | 2010-11-10 |
Last Update Date | 2016-01-25 |