NPI | 1871349282 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 25082) |
Additional Taxonomies | 104100000X Social Worker (Licence: NY 893703164) |
Enumeration Date | 2024-04-26 |
Last Update Date | 2024-04-26 |