NPI | 1437616273 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 14249) |
Additional Taxonomies | 175T00000X Peer Specialist |
Enumeration Date | 2019-02-28 |
Last Update Date | 2023-02-14 |