| NPI | 1588092209 |
|---|---|
| Former Name | JAMES E. LISTON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-10-15 |
| Last Update Date | 2020-01-17 |