NPI | 1881764348 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VT 000014) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: VT 0890000161) |
Enumeration Date | 2006-11-09 |
Last Update Date | 2008-02-26 |