NPI | 1922172105 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 367) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 2496) |
101YP2500X Counselor, Professional (Licence: NE 1357) | |
Enumeration Date | 2006-11-20 |
Last Update Date | 2024-09-05 |