| NPI | 1740766849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CA R1542370124) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 104100000X Social Worker | |
| Enumeration Date | 2018-07-12 |
| Last Update Date | 2024-01-18 |