NPI | 1578840344 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PR 64089) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: PR 10633) |
104100000X Social Worker (Licence: PR 10633) | |
Enumeration Date | 2011-11-08 |
Last Update Date | 2023-07-05 |