NPI | 1205485125 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 175T00000X Peer Specialist |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-09-04 |
Last Update Date | 2023-11-09 |