NPI | 1932636487 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA CAODC6453) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 4376-i) | |
Enumeration Date | 2017-05-15 |
Last Update Date | 2018-12-20 |