| NPI | 1265953939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA Aii051300218) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 164498IV) | |
| 101YM0800X Counselor, Mental Health | |
| 171M00000X Case Manager/Care Coordinator | |
| 172A00000X Driver | |
| 172V00000X Community Health Worker | |
| 175T00000X Peer Specialist | |
| 225C00000X Rehabilitation Counselor | |
| 251B00000X Case Management | |
| 251S00000X | |
| 253Z00000X In Home Supportive Care | |
| Enumeration Date | 2017-07-03 |
| Last Update Date | 2022-05-12 |