NPI | 1528629789 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: S.0020298) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LICDC.131023) |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2019-06-27 |
Last Update Date | 2023-05-18 |