NPI | 1205621414 |
---|---|
Other Name | ANDY LEE |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CT 8277) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 8277) |
Enumeration Date | 2025-04-10 |
Last Update Date | 2025-04-10 |