| NPI | 1437360179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OK 8572-p) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: under supervision) |
| 171M00000X Case Manager/Care Coordinator (Licence: OK 311838) | |
| 251B00000X Case Management | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2023-05-03 |