| NPI | 1184164709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR 19-QMHA-I-01453) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 23-11-20358) |
| 171M00000X Case Manager/Care Coordinator | |
| 172V00000X Community Health Worker (Licence: OR THW 1681) | |
| 175T00000X Peer Specialist (Licence: OR THW 1681) | |
| Enumeration Date | 2017-03-01 |
| Last Update Date | 2024-04-05 |