| NPI | 1780187799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO LPC.0020290) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACD.0002120) |
| 106H00000X Marriage & Family Therapist (Licence: CO MFTC.0014101) | |
| Enumeration Date | 2018-03-15 |
| Last Update Date | 2024-05-09 |