| NPI | 1669874459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA C060580919) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA l0907011902) |
| 101YM0800X Counselor, Mental Health (Licence: CA C060580919) | |
| 101YP2500X Counselor, Professional (Licence: CA C060580919) | |
| 171400000X Health & Wellness Coach (Licence: CA C060580919) | |
| Enumeration Date | 2014-09-23 |
| Last Update Date | 2021-12-09 |