| NPI | 1346490729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 13-06-87U3) | |
| 101YP2500X Counselor, Professional | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2024-08-14 |