NPI | 1538537741 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor Professional (Licence: TX 71257) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TX 11940) |
Enumeration Date | 2015-09-03 |
Last Update Date | 2015-09-03 |