| NPI | 1386002293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 106H00000X Marriage & Family Therapist (Licence: CA 98801) | |
| 171M00000X Case Manager/Care Coordinator | |
| 225400000X Rehabilitation Practitioner | |
| Enumeration Date | 2016-02-05 |
| Last Update Date | 2023-06-26 |