NPI | 1942549647 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
101YA0400X Counselor, Addiction (Substance Use Disorder) | |
Enumeration Date | 2013-01-31 |
Last Update Date | 2024-01-13 |