NPI | 1174857734 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2009-09-29 |
Last Update Date | 2010-02-02 |