NPI | 1154472769 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: DE PC-0000068) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: DE PC-0000068) |
Enumeration Date | 2007-01-12 |
Last Update Date | 2007-07-08 |