| NPI | 1346337656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCS 28197) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA H0504101828) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health (Licence: MI 6801083726) | |
| 101YP1600X Counselor, Pastoral | |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2018-02-08 |