NPI | 1841981198 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CO MFT.0001312) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACD.0001257) |
Enumeration Date | 2023-05-17 |
Last Update Date | 2023-05-17 |