NPI | 1215199633 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225400000X Rehabilitation Practitioner |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2008-06-26 |
Last Update Date | 2013-06-17 |