NPI | 1619343027 |
---|---|
Professional Name | JASON MILTON HEAD |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 175T00000X Peer Specialist (Licence: OR 17-CRM-032) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 15-5-14) |
Enumeration Date | 2015-08-19 |
Last Update Date | 2019-12-05 |