NPI | 1144736240 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 16344) |
Additional Taxonomies | 104100000X Social Worker (Licence: TX 64944) |
Enumeration Date | 2017-12-27 |
Last Update Date | 2022-11-21 |