NPI | 1932949906 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 87974) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 16347) |
101YM0800X Counselor, Mental Health (Licence: TX 87974) | |
Enumeration Date | 2024-05-28 |
Last Update Date | 2024-08-08 |