NPI | 1326702572 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 175T00000X Peer Specialist |
Additional Taxonomies | 106S00000X Behavior Technician |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2021-10-25 |
Last Update Date | 2024-02-21 |