| NPI | 1811352677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NJ 37PC00516900) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37LC00254100) |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2015-12-22 |
| Last Update Date | 2026-01-14 |