NPI | 1528112570 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 881) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
101YM0800X Counselor, Mental Health (Licence: LA 881) | |
Enumeration Date | 2007-01-23 |
Last Update Date | 2024-08-28 |