NPI | 1902345432 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist |
Enumeration Date | 2017-02-16 |
Last Update Date | 2023-04-03 |