NPI | 1497090658 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
Additional Taxonomies | 103K00000X Behavior Analyst |
Enumeration Date | 2012-11-29 |
Last Update Date | 2014-07-01 |