NPI | 1265818876 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225400000X Rehabilitation Practitioner |
Additional Taxonomies | 106S00000X Behavior Technician |
171M00000X Case Manager/Care Coordinator | |
251B00000X Case Management | |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2015-08-05 |
Last Update Date | 2025-07-16 |