| NPI | 1598006827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO LPC0011971) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CO LPC0011971) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO LPC0011971) | |
| 101YP2500X Counselor, Professional (Licence: CO LPC0011971) | |
| Enumeration Date | 2013-03-12 |
| Last Update Date | 2018-12-19 |