NPI | 1821569963 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106S00000X Behavior Technician (Licence: WA CG60525494) |
Additional Taxonomies | 101Y00000X Counselor (Licence: WA HP60781328) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CO60917941) | |
101YM0800X Counselor, Mental Health (Licence: WA CG60525494) | |
Enumeration Date | 2018-12-16 |
Last Update Date | 2021-01-22 |