NPI | 1124755715 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AR P2507012) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 91413) |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2022-08-03 |
Last Update Date | 2025-07-22 |