NPI | 1083262141 |
---|---|
Former Name | ROBERT C PRESTON |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR R8792) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 22-R-13) |
101YM0800X Counselor, Mental Health (Licence: OR 22-QMHPC-001173) | |
Enumeration Date | 2019-08-30 |
Last Update Date | 2025-01-01 |