NPI | 1245632215 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor Professional (Licence: OR C4837) |
Additional Taxonomies | 101Y00000X Counselor |
101YA0400X Counselor Addiction (Substance Use Disorder) | |
101YM0800X Counselor Mental Health | |
Enumeration Date | 2014-09-22 |
Last Update Date | 2018-04-16 |