| NPI | 1477561116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149004694) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 149004694) |
| 101YM0800X Counselor, Mental Health (Licence: IL 149004694) | |
| 101YP1600X Counselor, Pastoral | |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2010-03-11 |