NPI | 1841941499 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 17453) |
Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA R1404530920) |
101YA0400X Counselor, Addiction (Substance Use Disorder) | |
171M00000X Case Manager/Care Coordinator | |
175T00000X Peer Specialist | |
Enumeration Date | 2022-01-14 |
Last Update Date | 2024-04-19 |