NPI | 1881147460 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 304209) |
Additional Taxonomies | 101Y00000X Counselor (Licence: MN 304209) |
Enumeration Date | 2016-07-29 |
Last Update Date | 2016-08-16 |