| NPI | 1427815836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 284933) |
| Additional Taxonomies | 171400000X Health & Wellness Coach |
| 101YP1600X Counselor, Pastoral | |
| 225400000X Rehabilitation Practitioner | |
| 172V00000X Community Health Worker | |
| 172V00000X Community Health Worker (Licence: MD 00801-21-A) | |
| 174H00000X Health Educator | |
| 175T00000X Peer Specialist | |
| 175T00000X Peer Specialist (Licence: MD PR0394) | |
| Enumeration Date | 2024-03-01 |
| Last Update Date | 2024-03-01 |