NPI | 1316565617 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OK 102790) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2020-07-13 |
Last Update Date | 2024-12-28 |