NPI | 1144785338 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WA 1144785338) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2019-02-01 |
Last Update Date | 2021-09-13 |