| NPI | 1396592713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA R1583851024) | |
| 171400000X Health & Wellness Coach | |
| 171M00000X Case Manager/Care Coordinator | |
| 175T00000X Peer Specialist (Licence: CA MPSS-FXZUKN) | |
| Enumeration Date | 2024-05-03 |
| Last Update Date | 2024-12-13 |