| NPI | 1457032302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CO ACC.0998659) |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 101YP1600X Counselor Pastoral | |
| 101Y00000X Counselor | |
| 101YM0800X Counselor Mental Health | |
| Enumeration Date | 2023-07-25 |
| Last Update Date | 2023-07-25 |