| NPI | 1881091932 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC A11192) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC A11192) |
| Enumeration Date | 2014-12-04 |
| Last Update Date | 2014-12-04 |