NPI | 1871355685 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 13718) |
Additional Taxonomies | 101Y00000X Counselor (Licence: NE 13718) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 13718) | |
101YP2500X Counselor, Professional (Licence: NE 13718) | |
Enumeration Date | 2024-01-26 |
Last Update Date | 2024-03-09 |