| NPI | 1295611374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 104100000X Social Worker |
| 171M00000X Case Manager/Care Coordinator | |
| 103K00000X Behavior Analyst | |
| 376G00000X Nursing Home Administrator (Licence: TN 4492) | |
| 101YP1600X Counselor, Pastoral | |
| 101200000X Drama Therapist | |
| 101YS0200X Counselor, School | |
| 106H00000X Marriage & Family Therapist | |
| 183700000X Pharmacy Technician | |
| Enumeration Date | 2025-08-13 |
| Last Update Date | 2025-10-11 |