| NPI | 1588814529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CO 922) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CO ACD -272) |
| Enumeration Date | 2008-09-26 |
| Last Update Date | 2022-11-20 |