NPI | 1144532441 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 101Y00000X Counselor |
101YA0400X Counselor, Addiction (Substance Use Disorder) | |
Enumeration Date | 2010-07-02 |
Last Update Date | 2010-07-02 |