NPI | 1336433267 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 101Y00000X Counselor |
101YA0400X Counselor, Addiction (Substance Use Disorder) | |
101YM0800X Counselor, Mental Health | |
101YP2500X Counselor, Professional | |
Enumeration Date | 2011-06-08 |
Last Update Date | 2012-10-17 |