| NPI | 1144055948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: AK 2201754) |
| Enumeration Date | 2024-09-03 |
| Last Update Date | 2026-01-05 |