NPI | 1992262067 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR R8747) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR T-24-3960) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE P-1905) | |
101YM0800X Counselor, Mental Health (Licence: NE 12710) | |
Enumeration Date | 2019-02-25 |
Last Update Date | 2024-06-04 |