NPI | 1346328671 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37LC00032800) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NJ SC00205) |
Enumeration Date | 2006-11-02 |
Last Update Date | 2007-07-08 |