NPI | 1053897017 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CO61470827) |
Enumeration Date | 2018-07-12 |
Last Update Date | 2023-09-06 |