NPI | 1881754620 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 1903) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 433) |
101YP2500X Counselor, Professional (Licence: NE 1108) | |
101YM0800X Counselor, Mental Health (Licence: NE 691) | |
Enumeration Date | 2006-12-11 |
Last Update Date | 2010-10-26 |