NPI | 1114392214 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: LA 005361977) |
Enumeration Date | 2015-12-01 |
Last Update Date | 2018-08-02 |