NPI | 1770160467 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 103T00000X Psychologist |
101YA0400X Counselor, Addiction (Substance Use Disorder) | |
Enumeration Date | 2021-03-27 |
Last Update Date | 2021-03-27 |