NPI | 1144361924 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 09- R-15) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR 19-QMHPC-00775) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP00006216) | |
Enumeration Date | 2007-02-12 |
Last Update Date | 2020-02-12 |