NPI | 1114237294 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Additional Taxonomies | 372600000X Adult Companion |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2010-10-07 |
Last Update Date | 2010-10-21 |