NPI | 1487127999 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
106S00000X Behavior Technician | |
101Y00000X Counselor | |
Enumeration Date | 2019-01-07 |
Last Update Date | 2022-07-18 |