| NPI | 1396515789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA F4351321) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant |
| 146L00000X Emergency Medical Technician, Paramedic | |
| 146M00000X Emergency Medical Technician, Intermediate | |
| 146N00000X Emergency Medical Technician, Basic | |
| 171M00000X Case Manager/Care Coordinator | |
| 225800000X Recreation Therapist | |
| 226000000X Recreational Therapist Assistant | |
| 374K00000X | |
| 405300000X Prevention Professional (Licence: CA F4351321) | |
| Enumeration Date | 2024-01-05 |
| Last Update Date | 2024-01-11 |