| NPI | 1225494511 |
|---|---|
| Former Name | JOHN SALVADOR |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 10434) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2016-01-03 |
| Last Update Date | 2023-06-23 |