| NPI | 1174882484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NV 4541) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 225400000X Rehabilitation Practitioner | |
| Enumeration Date | 2012-05-07 |
| Last Update Date | 2024-04-22 |