NPI | 1386805562 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MA 855) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 1384) |
104100000X Social Worker (Licence: MA 208208) | |
Enumeration Date | 2008-06-20 |
Last Update Date | 2008-06-20 |