NPI | 1568057388 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
Additional Taxonomies | 101YM0800X Counselor Mental Health |
Enumeration Date | 2021-03-03 |
Last Update Date | 2022-09-15 |