NPI | 1578014247 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA D8295225) |
Enumeration Date | 2016-10-18 |
Last Update Date | 2018-04-18 |