| NPI | 1396430187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 175T00000X Peer Specialist | |
| 175T00000X Peer Specialist (Licence: NY CRPA-P-8188) | |
| 171400000X Health & Wellness Coach | |
| Enumeration Date | 2023-04-07 |
| Last Update Date | 2025-04-16 |