NPI | 1942356001 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA mft24309) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 24309) |
Enumeration Date | 2007-01-25 |
Last Update Date | 2014-08-11 |