NPI | 1700162393 |
---|---|
Other Name | GUS DIGGS |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: NC 5010) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Enumeration Date | 2011-10-26 |
Last Update Date | 2022-07-21 |