NPI | 1982150686 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT BBH-LAC-LIC-3375) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
101YA0400X Counselor, Addiction (Substance Use Disorder) | |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2016-09-01 |
Last Update Date | 2016-09-01 |