NPI | 1467603423 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C0671) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR C0671) |
101YP2500X Counselor, Professional (Licence: OR C0671) | |
Enumeration Date | 2008-10-08 |
Last Update Date | 2008-10-08 |