NPI | 1447827118 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 29757) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
101YM0800X Counselor, Mental Health | |
101YP2500X Counselor, Professional | |
101Y00000X Counselor | |
Enumeration Date | 2021-06-09 |
Last Update Date | 2023-04-04 |