NPI | 1346380144 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 12127) |
Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: WI 2179123) |
Enumeration Date | 2007-02-08 |
Last Update Date | 2007-07-08 |