NPI | 1346893294 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 15-05-09) |
Additional Taxonomies | 101Y00000X Counselor |
Enumeration Date | 2019-07-19 |
Last Update Date | 2022-12-12 |