NPI | 1154553766 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist |
Enumeration Date | 2009-08-14 |
Last Update Date | 2009-08-14 |