| NPI | 1306394242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 151125) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 6801119588) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0904018212) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 149.029127) | |
| 101YM0800X Counselor, Mental Health (Licence: OH S 1501039) | |
| 101YM0800X Counselor, Mental Health (Licence: MI 6801119588) | |
| 101YM0800X Counselor, Mental Health (Licence: VA 0904018212) | |
| 101YM0800X Counselor, Mental Health (Licence: IL 149.029127) | |
| 1041C0700X Social Worker, Clinical (Licence: VA 0904018212) | |
| 1041C0700X Social Worker, Clinical (Licence: OH S 1501039) | |
| 1041C0700X Social Worker, Clinical (Licence: MI 6801119588) | |
| 1041C0700X Social Worker, Clinical (Licence: IL 149.029127) | |
| Enumeration Date | 2016-09-21 |
| Last Update Date | 2025-08-20 |