NPI | 1689975286 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 900) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE P-876) |
101YM0800X Counselor, Mental Health (Licence: NE 8800) | |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 952) | |
101YM0800X Counselor, Mental Health (Licence: NE 1950) | |
Enumeration Date | 2010-11-12 |
Last Update Date | 2013-05-09 |