NPI | 1588127336 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 139837) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA A049600518) |
171M00000X Case Manager/Care Coordinator (Licence: CA A049600518) | |
225400000X Rehabilitation Practitioner (Licence: CA A049600518) | |
225C00000X Rehabilitation Counselor (Licence: CA A049600518) | |
Enumeration Date | 2019-04-09 |
Last Update Date | 2024-08-21 |