NPI | 1669724316 |
---|---|
Entity Type | Individual |
Gender | N/A |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 69067) |
106H00000X Marriage & Family Therapist (Licence: OR T0982) | |
101YA0400X Counselor, Addiction (Substance Use Disorder) | |
Enumeration Date | 2012-10-04 |
Last Update Date | 2024-04-25 |