NPI | 1427815836 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 175T00000X Peer Specialist (Licence: DC 259) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 284933) |
101YP1600X Counselor, Pastoral | |
171400000X Health & Wellness Coach | |
172V00000X Community Health Worker | |
172V00000X Community Health Worker (Licence: MD 00801-21-A) | |
174H00000X Health Educator | |
175T00000X Peer Specialist (Licence: MD PR0394) | |
225400000X Rehabilitation Practitioner | |
Enumeration Date | 2024-03-01 |
Last Update Date | 2025-06-27 |