NPI | 1306356597 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA A055190919) |
101YA0400X Counselor, Addiction (Substance Use Disorder) | |
Enumeration Date | 2017-10-03 |
Last Update Date | 2024-05-24 |