NPI | 1548871338 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC LCAS-26092) |
Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: NC P015251) |
Enumeration Date | 2020-08-14 |
Last Update Date | 2024-09-17 |