NPI | 1659671352 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR 3016) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2010-10-27 |
Last Update Date | 2014-11-20 |