NPI | 1538939137 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO 0020563) |
Additional Taxonomies | 101Y00000X Counselor (Licence: CO 0020563) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 0020563) | |
101YP2500X Counselor, Professional (Licence: CO 0020563) | |
Enumeration Date | 2024-01-04 |
Last Update Date | 2024-01-04 |