| NPI | 1699386326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: FL MCAP.0101081) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: FL CAP100138) |
| 101YM0800X Counselor Mental Health (Licence: FL 23209) | |
| 101YP1600X Counselor Pastoral | |
| Enumeration Date | 2020-08-14 |
| Last Update Date | 2023-03-10 |