NPI | 1336658301 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker Clinical |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
Enumeration Date | 2017-09-21 |
Last Update Date | 2023-11-08 |