NPI | 1477037562 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP60824124) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA MC60525348) |
Enumeration Date | 2018-09-24 |
Last Update Date | 2018-09-24 |