NPI | 1285238550 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO LPCC.0017457) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO LPCC.0017457) |
Enumeration Date | 2020-11-26 |
Last Update Date | 2020-12-28 |