| NPI | 1891929360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: DC PRC-1218) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: DC PRC-1218) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: DC M1220-2005) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: DC 203292) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: DC 013305) | |
| 101YM0800X Counselor, Mental Health (Licence: DC PRC1218) | |
| 101YP2500X Counselor, Professional (Licence: DC 6731) | |
| 103K00000X Behavior Analyst (Licence: DC 6731) | |
| Enumeration Date | 2009-05-12 |
| Last Update Date | 2009-05-12 |