| NPI | 1306530670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 251B00000X Case Management |
| 101YM0800X Counselor, Mental Health | |
| 171M00000X Case Manager/Care Coordinator | |
| 172V00000X Community Health Worker (Licence: TX 14456) | |
| 101YP1600X Counselor, Pastoral | |
| Enumeration Date | 2023-06-07 |
| Last Update Date | 2026-06-24 |