| NPI | 1134812019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174H00000X Health Educator |
| Additional Taxonomies | 174400000X Specialist |
| 101Y00000X Counselor | |
| 172V00000X Community Health Worker | |
| 171M00000X Case Manager/Care Coordinator | |
| 106H00000X Marriage & Family Therapist | |
| 373H00000X Day Training/Habilitation Specialist | |
| 106S00000X Behavior Technician (Licence: GA 106) | |
| 372600000X Adult Companion | |
| 103G00000X Clinical Neuropsychologist | |
| 251E00000X Home Health | |
| 372500000X Chore Provider | |
| 103T00000X Psychologist | |
| 104100000X Social Worker | |
| Enumeration Date | 2023-05-29 |
| Last Update Date | 2026-08-11 |