| NPI | 1275709826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 6802067415) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6802067415) |
| 101YP1600X Counselor, Pastoral (Licence: MI 6802067415) | |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2009-06-26 |