NPI | 1396236386 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Additional Taxonomies | 101Y00000X Counselor |
172V00000X Community Health Worker | |
Enumeration Date | 2018-05-24 |
Last Update Date | 2021-01-28 |