| NPI | 1043464217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WI 4122-125) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OK 5505) |
| 101YM0800X Counselor, Mental Health (Licence: OK 5505) | |
| 101YM0800X Counselor, Mental Health (Licence: WI 4122-125) | |
| 101YP2500X Counselor, Professional (Licence: OK 5505) | |
| 101YP2500X Counselor, Professional (Licence: IL 180007427) | |
| 101YP2500X Counselor, Professional (Licence: WI 4122-125) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: WI 4122-125) | |
| 171M00000X Case Manager/Care Coordinator | |
| 172V00000X Community Health Worker | |
| 225C00000X Rehabilitation Counselor (Licence: WI 00094293) | |
| 225C00000X Rehabilitation Counselor (Licence: IL 00094293) | |
| 225CA2400X Rehabilitation Counselor, Assistive Technology Practitioner (Licence: WI 00094293) | |
| 225CA2500X Rehabilitation Counselor, Assistive Technology Supplier (Licence: WI 00094293) | |
| Enumeration Date | 2008-11-13 |
| Last Update Date | 2022-07-21 |