| NPI | 1780832030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: KS 158) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: KS 305) | |
| 101YM0800X Counselor Mental Health (Licence: KS 4283) | |
| 104100000X Social Worker (Licence: KS 7740) | |
| Enumeration Date | 2008-08-28 |
| Last Update Date | 2018-03-29 |