NPI | 1033862230 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA R1504050423) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
175T00000X Peer Specialist | |
Enumeration Date | 2022-01-28 |
Last Update Date | 2024-05-03 |