NPI | 1578003331 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA Certification) |
Enumeration Date | 2017-02-27 |
Last Update Date | 2017-04-05 |