| NPI | 1437305893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: RI LMHC) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: RI LCDP) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2008-08-16 |
| Last Update Date | 2019-08-28 |