NPI | 1407288103 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor |
Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6401013680) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 6401013680) | |
101YM0800X Counselor, Mental Health (Licence: MI 6401013680) | |
101YP2500X Counselor, Professional (Licence: CO LPC.0014257) | |
101YP2500X Counselor, Professional (Licence: MI 6401013680) | |
Enumeration Date | 2013-08-05 |
Last Update Date | 2023-03-14 |