NPI | 1356500920 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA MFC23931) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA MFC23931) |
Enumeration Date | 2008-06-08 |
Last Update Date | 2008-06-08 |