NPI | 1366118390 |
---|---|
Other Name | JONATHAN R FARRELL |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 172V00000X Community Health Worker (Licence: CA 95857) |
Additional Taxonomies | 101Y00000X Counselor (Licence: CA 95857) |
Enumeration Date | 2021-08-19 |
Last Update Date | 2023-04-04 |