NPI | 1336177385 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PA SW008994-L) |
Enumeration Date | 2006-06-29 |
Last Update Date | 2007-07-08 |