NPI | 1265596035 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH8204) |
Additional Taxonomies | 104100000X Social Worker |
171M00000X Case Manager/Care Coordinator (Licence: FL MH8204) | |
Enumeration Date | 2006-12-19 |
Last Update Date | 2018-09-25 |