| NPI | 1174198790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP1600X Counselor, Pastoral |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 171400000X Health & Wellness Coach | |
| 171M00000X Case Manager/Care Coordinator | |
| 171R00000X Interpreter | |
| 171W00000X Contractor | |
| 172V00000X Community Health Worker | |
| 174H00000X Health Educator | |
| 225C00000X Rehabilitation Counselor | |
| 374K00000X Religious Nonmedical Practitioner | |
| Enumeration Date | 2021-05-25 |
| Last Update Date | 2021-05-26 |