| NPI | 1053757880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C6991) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA 60961479) |
| 101Y00000X Counselor (Licence: OR 6991) | |
| 101Y00000X Counselor (Licence: OR R6261) | |
| 101Y00000X Counselor (Licence: OR C6991) | |
| 101YM0800X Counselor, Mental Health (Licence: OR R6261) | |
| 101YP2500X Counselor, Professional (Licence: OR 6991) | |
| 101YP2500X Counselor, Professional (Licence: OR C6991) | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2013-05-20 |
| Last Update Date | 2023-03-06 |