NPI | 1104295831 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
101YP2500X Counselor, Professional | |
101YS0200X Counselor, School | |
Enumeration Date | 2015-09-23 |
Last Update Date | 2019-10-15 |