NPI | 1386156735 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Additional Taxonomies | 101YP2500X Counselor, Professional |
Enumeration Date | 2017-10-25 |
Last Update Date | 2023-12-21 |