NPI | 1134528599 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Additional Taxonomies | 101Y00000X Counselor (Licence: WA co60178687) |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2014-08-21 |
Last Update Date | 2014-08-21 |