| NPI | 1225271422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC004345) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: GA NCC 210724) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA C0040) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN MAC 12619) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA ICAADC 202225) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA CCODP-D 0004) | |
| 101YM0800X Counselor, Mental Health (Licence: GA ACS 00557) | |
| 174400000X Specialist (Licence: IN CFAS 12619) | |
| 174400000X Specialist (Licence: IN BDFC 12619) | |
| Enumeration Date | 2009-04-17 |
| Last Update Date | 2015-01-05 |