| NPI | 1538220744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: TN 00856) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TN 00856) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TN 00856) | |
| 101YM0800X Counselor Mental Health (Licence: TN 00856) | |
| 101YS0200X Counselor School | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2009-09-17 |