NPI | 1497243109 |
---|---|
Other Name | LAWRENCE TAYLOR |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 15-CRM-017) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR 19-QMHA-I-00478) |
175T00000X Peer Specialist (Licence: OR THW000002408) | |
Enumeration Date | 2018-04-27 |
Last Update Date | 2019-04-17 |