NPI | 1780038463 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL ADC-013662-2016) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2016-04-19 |
Last Update Date | 2016-05-25 |