NPI | 1942906201 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: FL MT3349) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP60537148) |
Enumeration Date | 2023-02-07 |
Last Update Date | 2023-02-07 |