| NPI | 1881438901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 90504) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: 1725464) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 16532) | |
| 101YM0800X Counselor, Mental Health (Licence: TX 90504) | |
| 225C00000X Rehabilitation Counselor (Licence: 477427) | |
| Enumeration Date | 2024-06-24 |
| Last Update Date | 2024-10-07 |