NPI | 1275018152 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR T-18-429) |
Enumeration Date | 2018-09-26 |
Last Update Date | 2019-01-14 |