NPI | 1699264184 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW17581) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL ADC-009399-2015) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 804596) | |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 16360816) | |
Enumeration Date | 2018-05-09 |
Last Update Date | 2020-10-20 |