| NPI | 1023700945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO CSW.09933252) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 104100000X Social Worker (Licence: OH S.2309453) | |
| Enumeration Date | 2023-05-22 |
| Last Update Date | 2026-07-06 |