| NPI | 1255217998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPCC.0023748) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACA.0008282) |
| 101YM0800X Counselor, Mental Health (Licence: CO LPCC.0023748) | |
| Enumeration Date | 2025-08-15 |
| Last Update Date | 2025-08-28 |