NPI | 1083007033 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 373H00000X Day Training/Habilitation Specialist |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
172V00000X Community Health Worker | |
Enumeration Date | 2015-03-16 |
Last Update Date | 2025-03-24 |