NPI | 1538941711 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 175T00000X Peer Specialist (Licence: CA MPSS-YOUADE) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 16112) |
Enumeration Date | 2023-10-20 |
Last Update Date | 2024-04-09 |