NPI | 1154652634 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ND 666-9-1-10-243) |
Additional Taxonomies | 101Y00000X Counselor (Licence: ND 666-9-1-10-243) |
101Y00000X Counselor (Licence: MN cc01903) | |
101YP2500X Counselor, Professional (Licence: MN cc01903) | |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2010-01-22 |
Last Update Date | 2023-01-11 |