NPI | 1598773608 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 061188U3) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR C1884) |
101YP2500X Counselor, Professional (Licence: OR C1884) | |
Enumeration Date | 2006-08-04 |
Last Update Date | 2025-09-11 |