| NPI | 1285972661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OK 6993) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OK 6993) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2013-01-20 |
| Last Update Date | 2024-12-18 |