NPI | 1083495436 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP00005435) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical |
Enumeration Date | 2023-10-11 |
Last Update Date | 2023-10-11 |