NPI | 1740419035 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor (Licence: TX N/A) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX N/A) |
101YP1600X Counselor, Pastoral (Licence: TX N/A) | |
Enumeration Date | 2009-07-07 |
Last Update Date | 2009-07-07 |