NPI | 1114663622 |
---|---|
Former Name | CRAIG O'MEARA |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 106S00000X Behavior Technician (Licence: OR 21-QMHA-I-003238) |
Enumeration Date | 2022-05-08 |
Last Update Date | 2022-05-15 |