NPI | 1447934583 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 92485) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 64017) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 16666) | |
Enumeration Date | 2023-06-09 |
Last Update Date | 2023-08-25 |