NPI | 1164437893 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 4977) |
Enumeration Date | 2006-07-30 |
Last Update Date | 2007-07-09 |