NPI | 1851767305 |
---|---|
Other Name | MATT RYAN ANGLEMAN |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO LPC.0014852) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Enumeration Date | 2015-08-19 |
Last Update Date | 2020-08-30 |