| NPI | 1306329453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional (Licence: TX 86482) | |
| Enumeration Date | 2018-09-13 |
| Last Update Date | 2022-08-10 |