NPI | 1396479655 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37CA00187500) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
171M00000X Case Manager/Care Coordinator (Licence: NJ 37CA00187500) | |
Enumeration Date | 2022-07-13 |
Last Update Date | 2024-04-24 |