NPI | 1902370604 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Additional Taxonomies | 103K00000X Behavior Analyst |
Enumeration Date | 2019-01-15 |
Last Update Date | 2019-06-27 |