NPI | 1194058628 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 373H00000X Day Training/Habilitation Specialist |
Additional Taxonomies | 101Y00000X Counselor |
171M00000X Case Manager/Care Coordinator | |
172V00000X Community Health Worker | |
225400000X Rehabilitation Practitioner | |
Enumeration Date | 2009-09-16 |
Last Update Date | 2025-08-29 |