NPI | 1861977134 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Additional Taxonomies | 106S00000X Behavior Technician |
Enumeration Date | 2018-10-02 |
Last Update Date | 2022-09-08 |