| NPI | 1184106981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA CG60935274) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 171M00000X Case Manager/Care Coordinator (Licence: WA CG60935274) | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2018-08-29 |
| Last Update Date | 2019-04-24 |