NPI | 1285640581 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MO 4917) |
Additional Taxonomies | 251S00000X |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2006-07-31 |
Last Update Date | 2010-09-02 |