NPI | 1861505034 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: OK 1603) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OK 21) |
101YM0800X Counselor, Mental Health (Licence: OK 1603) | |
101YP2500X Counselor, Professional (Licence: OK 1603) | |
106H00000X Marriage & Family Therapist (Licence: OK 724) | |
Enumeration Date | 2006-08-15 |
Last Update Date | 2007-07-08 |