NPI | 1194315770 |
---|---|
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 | 2021-01-19 |
Last Update Date | 2022-10-17 |