NPI | 1467227223 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225C00000X Rehabilitation Counselor (Licence: IL 397297) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 17591) |
101YP2500X Counselor, Professional (Licence: IL 178.018669) | |
Enumeration Date | 2023-11-21 |
Last Update Date | 2023-11-28 |