NPI | 1831804327 |
---|---|
Entity Type | Individual |
Gender | N/A |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR T-24-3445) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OR L16975) |
Enumeration Date | 2023-01-18 |
Last Update Date | 2025-09-06 |