NPI | 1023655289 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR T-22-1605) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR TG-22-078) | |
101Y00000X Counselor | |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2019-12-06 |
Last Update Date | 2022-04-28 |