NPI | 1134704737 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
101YP1600X Counselor, Pastoral | |
101YP2500X Counselor, Professional | |
106H00000X Marriage & Family Therapist | |
Enumeration Date | 2021-03-15 |
Last Update Date | 2021-03-15 |