| NPI | 1972241131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN 86000400A) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TN 5820) |
| 104100000X Social Worker (Licence: TN 13690) | |
| 104100000X Social Worker (Licence: IN 33010944A) | |
| Enumeration Date | 2022-05-26 |
| Last Update Date | 2023-02-22 |