| NPI | 1396175949 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP2500X Counselor, Professional | 
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: DC RN200001533) | 
| 171M00000X Case Manager/Care Coordinator | |
| 251B00000X Case Management | |
| 374U00000X Home Health Aide | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-11-18 | 
| Last Update Date | 2024-08-25 |