| NPI | 1548314073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH60431060) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR C3416) |
| 101YM0800X Counselor, Mental Health (Licence: OR C3416) | |
| 101YP2500X Counselor, Professional (Licence: OR C3416) | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2018-03-21 |