NPI | 1255426896 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MI 4101006000) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 102179) |
1041C0700X Social Worker, Clinical (Licence: MI 6801010915) | |
Enumeration Date | 2006-10-03 |
Last Update Date | 2025-09-11 |