NPI | 1821451295 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor |
Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6401017030) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 6401013114) | |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 6401017030) | |
Enumeration Date | 2016-04-01 |
Last Update Date | 2022-02-22 |