| NPI | 1235810672 |
|---|---|
| Former Name | JUSTIN HARRISON SILVA |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: OR 25-CRM-4079) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2023-07-27 |
| Last Update Date | 2025-01-22 |