| NPI | 1548571516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC007808) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP1600X Counselor, Pastoral (Licence: PA PC007808) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PA PC007808) | |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2022-06-28 |