| NPI | 1477843902 | 
|---|---|
| Professional Name | MARIO MACIAS | 
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA IMF73931)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) | 
| Enumeration Date | 2011-04-18 | 
| Last Update Date | 2015-02-19 |