NPI | 1396452330 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OK LPCCANDIDATE12519) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: OK 317198) |
175T00000X Peer Specialist (Licence: OK 134121) | |
Enumeration Date | 2022-10-31 |
Last Update Date | 2024-12-02 |