NPI | 1770816738 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH17441) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL MH17441) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2009-09-09 |
Last Update Date | 2020-01-09 |