NPI | 1164969044 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: CO ACB.0008142) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACB.0008142) |
101YM0800X Counselor, Mental Health (Licence: CO ACB.0008142) | |
Enumeration Date | 2017-01-30 |
Last Update Date | 2017-01-30 |