| NPI | 1497372858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NV CI2915) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NV 2440-I) |
| Enumeration Date | 2020-07-01 |
| Last Update Date | 2020-09-24 |