NPI | 1669662045 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA Aii5411214) |
Additional Taxonomies | 405300000X Prevention Professional (Licence: CA CPS0281116) |
175T00000X Peer Specialist | |
Enumeration Date | 2007-07-31 |
Last Update Date | 2017-03-02 |