NPI | 1114268588 |
---|---|
Former Name | KEITH HAROLD THIGPEN |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 101Y00000X Counselor (Licence: CA A022760416) |
101YA0400X Counselor, Addiction (Substance Use Disorder) | |
Enumeration Date | 2013-03-11 |
Last Update Date | 2024-08-27 |