NPI | 1366024788 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2021-04-26 |
Last Update Date | 2023-05-30 |