NPI | 1902079122 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2008-04-09 |
Last Update Date | 2013-07-12 |