NPI | 1619412236 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: TX 60937) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 13639) |
Enumeration Date | 2017-01-05 |
Last Update Date | 2017-01-05 |