| NPI | 1952381337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: HI LCSW3213) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: HI LCSW3213) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: HI CSAC 692-7522-7517) | |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2016-01-12 |