| NPI | 1548810898 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP1600X Counselor, Pastoral (Licence: HI 2009-835) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: HI 1564-10) | |
| 101YM0800X Counselor, Mental Health (Licence: HI MHC-636) | |
| Enumeration Date | 2019-09-18 |
| Last Update Date | 2019-09-24 |