| NPI | 1699092908 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 14-R-09) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP60126403) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA RC00052055) | |
| Enumeration Date | 2010-04-26 |
| Last Update Date | 2016-04-20 |