| NPI | 1437407780 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL IMH12501) |
| Additional Taxonomies | 171W00000X Contractor |
| 171M00000X Case Manager/Care Coordinator | |
| 172A00000X Driver | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-08-16 |
| Last Update Date | 2021-01-23 |