NPI | 1285299222 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 121695) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2019-05-06 |
Last Update Date | 2020-10-12 |