NPI | 1851912166 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
106H00000X Marriage & Family Therapist | |
Enumeration Date | 2020-04-28 |
Last Update Date | 2022-05-05 |