| NPI | 1356677421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH 8545) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL CAP 2482) |
| 101YM0800X Counselor, Mental Health (Licence: FL MH8545) | |
| Enumeration Date | 2009-10-26 |
| Last Update Date | 2022-03-08 |