NPI | 1346568920 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Additional Taxonomies | 101Y00000X Counselor (Licence: CA RS5862) |
Enumeration Date | 2010-05-06 |
Last Update Date | 2022-07-21 |