| NPI | 1952550220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MO 2007035389) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MO 2007035389) |
| 101YM0800X Counselor, Mental Health (Licence: MO 2007035389) | |
| 101YP1600X Counselor, Pastoral (Licence: MO 2007035389) | |
| Enumeration Date | 2008-09-11 |
| Last Update Date | 2008-09-11 |