NPI | 1811275498 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NV 01495-L) |
Additional Taxonomies | 104100000X Social Worker (Licence: NV 6331-S) |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2011-07-29 |
Last Update Date | 2013-06-25 |