| NPI | 1245691104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 104100000X Social Worker (Licence: WA CG60320739) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2016-03-18 |
| Last Update Date | 2024-01-23 |