| NPI | 1285273318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CO MFTC.0014400) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACD.0002505) |
| Enumeration Date | 2020-01-06 |
| Last Update Date | 2024-10-21 |