NPI | 1831669043 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MS 2335) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MS 2335) |
101YM0800X Counselor, Mental Health (Licence: MS 2335) | |
Enumeration Date | 2018-11-30 |
Last Update Date | 2020-12-01 |