NPI | 1215249602 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: NY P80372) |
Enumeration Date | 2010-07-14 |
Last Update Date | 2012-02-08 |