| NPI | 1447369384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH 991493) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: OH E0003981) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2007-07-08 |